Robotic Versus Open Pancreatoduodenectomy With Vein Resection and Reconstruction: A Propensity Score-Matched Analysis
Objective:. This study aimed to compare robotic pancreatoduodenectomy with vein resection (PD-VR) based on the incidence of severe postoperative complications (SPC). Background:. Robotic pancreatoduodenectomy has been gaining momentum in recent years. Vein resection is frequently required in this op...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Health
2024-06-01
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| Series: | Annals of Surgery Open |
| Online Access: | http://journals.lww.com/10.1097/AS9.0000000000000409 |
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| author | Niccolò Napoli, MD, PhD, FEBS Emanuele Federico Kauffmann, MD, PhD, FEBS Michael Ginesini, MD Armando Di Dato, MD Virginia Viti, MD Cesare Gianfaldoni, MD Lucrezia Lami, MD Carla Cappelli, MD Maria Isabella Rotondo, MD Daniela Campani, MD Gabriella Amorese, MD Caterina Vivaldi, MD Silvia Cesario, MD Laura Bernardini, MD Enrico Vasile, MD Fabio Vistoli, MD, PhD, FEBS Ugo Boggi, MD, FEBS |
| author_facet | Niccolò Napoli, MD, PhD, FEBS Emanuele Federico Kauffmann, MD, PhD, FEBS Michael Ginesini, MD Armando Di Dato, MD Virginia Viti, MD Cesare Gianfaldoni, MD Lucrezia Lami, MD Carla Cappelli, MD Maria Isabella Rotondo, MD Daniela Campani, MD Gabriella Amorese, MD Caterina Vivaldi, MD Silvia Cesario, MD Laura Bernardini, MD Enrico Vasile, MD Fabio Vistoli, MD, PhD, FEBS Ugo Boggi, MD, FEBS |
| author_sort | Niccolò Napoli, MD, PhD, FEBS |
| collection | DOAJ |
| description | Objective:. This study aimed to compare robotic pancreatoduodenectomy with vein resection (PD-VR) based on the incidence of severe postoperative complications (SPC).
Background:. Robotic pancreatoduodenectomy has been gaining momentum in recent years. Vein resection is frequently required in this operation, but no study has compared robotic and open PD-VR using a matched analysis.
Methods:. This was an intention-to-treat study designed to demonstrate the noninferiority of robotic to open PD-VR (2011–2021) based on SPC. To achieve a power of 80% (noninferiority margin:10%; α error: 0.05; ß error: 0.20), a 1:1 propensity score-matched analysis required 35 pairs.
Results:. Of the 151 patients with PD-VR (open = 115, robotic = 36), 35 procedures per group were compared. Elective conversion to open surgery was required in 1 patient with robotic PD-VR (2.9%). One patient in both groups experienced partial vein thrombosis. SPC occurred in 7 (20.0%) and 6 patients (17.1%) in the robotic and open PD-VR groups, respectively (P = 0.759; OR: 1.21 [0.36–4.04]). Three patients died after robotic PD-VR (8.6%) and none died after open PD-VR (P = 0.239). Robotic PD-VR was associated with longer operative time (611.1 ± 13.9 minutes vs 529.0 ± 13.0 minutes; P < 0.0001), more type 2 vein resection (28.6% vs 5.7%; P = 0.0234) and less type 3 vein resection (31.4% vs 71.4%; P = 0.0008), longer vein occlusion time (30 [25.3–78.3] minutes vs 15 [8–19.5] minutes; P = 0.0098), less blood loss (450 [200–750] mL vs 733 [500–1070.3] mL; P = 0.0075), and fewer blood transfusions (intraoperative: 14.3% vs 48.6%; P = 0.0041) (perioperative: 14.3% vs 60.0%; P = 0.0001).
Conclusions:. In this study, robotic PD-VR was noninferior to open PD-VR for SPC. Robotic and open PD-VR need to be compared in randomized controlled trials. |
| format | Article |
| id | doaj-art-f34201e7f52b45bf9e5205fb6012a91a |
| institution | Kabale University |
| issn | 2691-3593 |
| language | English |
| publishDate | 2024-06-01 |
| publisher | Wolters Kluwer Health |
| record_format | Article |
| series | Annals of Surgery Open |
| spelling | doaj-art-f34201e7f52b45bf9e5205fb6012a91a2025-01-24T09:18:39ZengWolters Kluwer HealthAnnals of Surgery Open2691-35932024-06-0152e40910.1097/AS9.0000000000000409202406000-00005Robotic Versus Open Pancreatoduodenectomy With Vein Resection and Reconstruction: A Propensity Score-Matched AnalysisNiccolò Napoli, MD, PhD, FEBS0Emanuele Federico Kauffmann, MD, PhD, FEBS1Michael Ginesini, MD2Armando Di Dato, MD3Virginia Viti, MD4Cesare Gianfaldoni, MD5Lucrezia Lami, MD6Carla Cappelli, MD7Maria Isabella Rotondo, MD8Daniela Campani, MD9Gabriella Amorese, MD10Caterina Vivaldi, MD11Silvia Cesario, MD12Laura Bernardini, MD13Enrico Vasile, MD14Fabio Vistoli, MD, PhD, FEBS15Ugo Boggi, MD, FEBS16* From the Division of General and Transplant Surgery, University of Pisa, Pisa, Italy* From the Division of General and Transplant Surgery, University of Pisa, Pisa, Italy* From the Division of General and Transplant Surgery, University of Pisa, Pisa, Italy* From the Division of General and Transplant Surgery, University of Pisa, Pisa, Italy* From the Division of General and Transplant Surgery, University of Pisa, Pisa, Italy* From the Division of General and Transplant Surgery, University of Pisa, Pisa, Italy* From the Division of General and Transplant Surgery, University of Pisa, Pisa, Italy† Division of Radiology, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy‡ Division of Pathology, University of Pisa, Pisa, Italy‡ Division of Pathology, University of Pisa, Pisa, Italy§ Division of Anesthesia and Intensive Care, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy‖ Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy¶ Division of Medical Oncology 2, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.¶ Division of Medical Oncology 2, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.¶ Division of Medical Oncology 2, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.* From the Division of General and Transplant Surgery, University of Pisa, Pisa, Italy* From the Division of General and Transplant Surgery, University of Pisa, Pisa, ItalyObjective:. This study aimed to compare robotic pancreatoduodenectomy with vein resection (PD-VR) based on the incidence of severe postoperative complications (SPC). Background:. Robotic pancreatoduodenectomy has been gaining momentum in recent years. Vein resection is frequently required in this operation, but no study has compared robotic and open PD-VR using a matched analysis. Methods:. This was an intention-to-treat study designed to demonstrate the noninferiority of robotic to open PD-VR (2011–2021) based on SPC. To achieve a power of 80% (noninferiority margin:10%; α error: 0.05; ß error: 0.20), a 1:1 propensity score-matched analysis required 35 pairs. Results:. Of the 151 patients with PD-VR (open = 115, robotic = 36), 35 procedures per group were compared. Elective conversion to open surgery was required in 1 patient with robotic PD-VR (2.9%). One patient in both groups experienced partial vein thrombosis. SPC occurred in 7 (20.0%) and 6 patients (17.1%) in the robotic and open PD-VR groups, respectively (P = 0.759; OR: 1.21 [0.36–4.04]). Three patients died after robotic PD-VR (8.6%) and none died after open PD-VR (P = 0.239). Robotic PD-VR was associated with longer operative time (611.1 ± 13.9 minutes vs 529.0 ± 13.0 minutes; P < 0.0001), more type 2 vein resection (28.6% vs 5.7%; P = 0.0234) and less type 3 vein resection (31.4% vs 71.4%; P = 0.0008), longer vein occlusion time (30 [25.3–78.3] minutes vs 15 [8–19.5] minutes; P = 0.0098), less blood loss (450 [200–750] mL vs 733 [500–1070.3] mL; P = 0.0075), and fewer blood transfusions (intraoperative: 14.3% vs 48.6%; P = 0.0041) (perioperative: 14.3% vs 60.0%; P = 0.0001). Conclusions:. In this study, robotic PD-VR was noninferior to open PD-VR for SPC. Robotic and open PD-VR need to be compared in randomized controlled trials.http://journals.lww.com/10.1097/AS9.0000000000000409 |
| spellingShingle | Niccolò Napoli, MD, PhD, FEBS Emanuele Federico Kauffmann, MD, PhD, FEBS Michael Ginesini, MD Armando Di Dato, MD Virginia Viti, MD Cesare Gianfaldoni, MD Lucrezia Lami, MD Carla Cappelli, MD Maria Isabella Rotondo, MD Daniela Campani, MD Gabriella Amorese, MD Caterina Vivaldi, MD Silvia Cesario, MD Laura Bernardini, MD Enrico Vasile, MD Fabio Vistoli, MD, PhD, FEBS Ugo Boggi, MD, FEBS Robotic Versus Open Pancreatoduodenectomy With Vein Resection and Reconstruction: A Propensity Score-Matched Analysis Annals of Surgery Open |
| title | Robotic Versus Open Pancreatoduodenectomy With Vein Resection and Reconstruction: A Propensity Score-Matched Analysis |
| title_full | Robotic Versus Open Pancreatoduodenectomy With Vein Resection and Reconstruction: A Propensity Score-Matched Analysis |
| title_fullStr | Robotic Versus Open Pancreatoduodenectomy With Vein Resection and Reconstruction: A Propensity Score-Matched Analysis |
| title_full_unstemmed | Robotic Versus Open Pancreatoduodenectomy With Vein Resection and Reconstruction: A Propensity Score-Matched Analysis |
| title_short | Robotic Versus Open Pancreatoduodenectomy With Vein Resection and Reconstruction: A Propensity Score-Matched Analysis |
| title_sort | robotic versus open pancreatoduodenectomy with vein resection and reconstruction a propensity score matched analysis |
| url | http://journals.lww.com/10.1097/AS9.0000000000000409 |
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