Robotic-Assisted versus Laparoscopic Distal Pancreatectomy: The Results of a Case-Matched Analysis from a Tertiary Care Center

摘要

<b><i>Background:</i></b> Laparoscopic distal pancreatectomy (LDP) has been adopted relatively slowly despite the benefits of minimally invasive approach. The robotic approach can overcome the limitations of LDP, thus increasing the acceptance of minimally invasive distal pancreatectomy. <b><i>Methods:</i></b> We performed a 1:1 retrospective case-matched comparison among 2 groups of 35 patients who underwent robotic-assisted distal pancreatectomy (RDP) or LDP from August 2014 to April 2017. <b><i>Results:</i></b> The operative time was similar in both groups (230 RDP vs. 205 LDP min, <i>p</i> = 0.382). The robotic group had a lower estimated blood loss (95 vs. 275 mL, <i>p</i> = 0.035). The spleen preservation rate was higher in the RDP group (100 vs. 66.7%, <i>p</i> = 0.027), while the conversion rate to open surgery was higher in the laparoscopic group (14.3 vs. 2.9%, <i>p</i> = 0.048). The overall complication rate was lower in the robotic group (25.7 vs. 37.1%, <i>p</i> = 0.044). There was no statistically significant difference in oncologic outcomes between the groups in terms of R0 resection rate (100% RDP vs. 85% LDP, <i>p</i> = 0.233) and number of harvested lymph nodes (14.4 RDP vs. 10.8 LDP, <i>p</i> = 0.678). <b><i>Conclusions:</i></b> The RDP showed a lower estimated blood loss, conversion, and morbidity rate. It offered a higher spleen preservation rate in comparison to LDP while maintaining comparable oncologic outcomes.