TY - JOUR
T1 - Robotic and open distal pancreatectomy with celiac axis resection for locally advanced pancreatic body tumors
T2 - a single institutional assessment of perioperative outcomes and survival
AU - Ocuin, Lee M.
AU - Miller-Ocuin, Jennifer L.
AU - Novak, Stephanie M.
AU - Bartlett, David L.
AU - Marsh, J. Wallis
AU - Tsung, Allan
AU - Lee, Kenneth K.
AU - Hogg, Melissa E.
AU - Zeh, Herbert J.
AU - Zureikat, Amer H.
N1 - Publisher Copyright:
© 2016 International Hepato-Pancreato-Biliary Association Inc.
PY - 2016/10/1
Y1 - 2016/10/1
N2 - Background Distal pancreatectomy with celiac axis resection (DP-CAR) is an option for T4 tumors of the pancreatic body. We examined the perioperative and oncologic outcomes of open and robotic DP-CAR at a high-volume pancreatic center. Methods Retrospective review of all consecutive DP-CARs. Patient demographics, 90-day perioperative outcomes, and disease specific survival were collected. Results 30 DP-CARs were performed (11 Robotic, 19 Open). Both groups had similar preoperative/tumor characteristics, and 27 of 28 PDA patients received neoadjuvant chemotherapy. Robotic DP-CAR was associated with decreased OT (316 vs. 476 min), reduced EBL (393 vs. 1736 ml) and lower rates of blood transfusion (0% vs. 54%) (all p < 0.05). No robotic DP-CAR required conversion. Both groups had similar rates of 90-day mortality, major morbidity, LOS, readmission, and receipt of adjuvant therapy. Similarly, both approaches were associated with high R0 resection rates (82% vs. 79%). At a median follow-up of 33 months, median overall survival for the PDA cohort was 35 months, with no difference in the robotic and open approach (33 and 40 months, p = 0.310). Conclusions With a median survival approaching 3 years, DP-CAR represents an effective treatment for select patients with locally advanced pancreatic body cancer, regardless of approach.
AB - Background Distal pancreatectomy with celiac axis resection (DP-CAR) is an option for T4 tumors of the pancreatic body. We examined the perioperative and oncologic outcomes of open and robotic DP-CAR at a high-volume pancreatic center. Methods Retrospective review of all consecutive DP-CARs. Patient demographics, 90-day perioperative outcomes, and disease specific survival were collected. Results 30 DP-CARs were performed (11 Robotic, 19 Open). Both groups had similar preoperative/tumor characteristics, and 27 of 28 PDA patients received neoadjuvant chemotherapy. Robotic DP-CAR was associated with decreased OT (316 vs. 476 min), reduced EBL (393 vs. 1736 ml) and lower rates of blood transfusion (0% vs. 54%) (all p < 0.05). No robotic DP-CAR required conversion. Both groups had similar rates of 90-day mortality, major morbidity, LOS, readmission, and receipt of adjuvant therapy. Similarly, both approaches were associated with high R0 resection rates (82% vs. 79%). At a median follow-up of 33 months, median overall survival for the PDA cohort was 35 months, with no difference in the robotic and open approach (33 and 40 months, p = 0.310). Conclusions With a median survival approaching 3 years, DP-CAR represents an effective treatment for select patients with locally advanced pancreatic body cancer, regardless of approach.
UR - http://www.scopus.com/inward/record.url?scp=84992745895&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84992745895&partnerID=8YFLogxK
U2 - 10.1016/j.hpb.2016.05.003
DO - 10.1016/j.hpb.2016.05.003
M3 - Article
C2 - 27506992
AN - SCOPUS:84992745895
SN - 1365-182X
VL - 18
SP - 835
EP - 842
JO - HPB
JF - HPB
IS - 10
ER -