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Uijterwijk, Bas [VerfasserIn]; Wei, Kongyuan [VerfasserIn]; Kasai, Meidai [VerfasserIn]; Ielpo, Benedetto [VerfasserIn]; Hilst, Jony van [VerfasserIn]; Chinnusamy, Palanivelu [VerfasserIn]; Lemmers, Daniel H. L. [VerfasserIn]; Burdio, Fernando [VerfasserIn]; Senthilnathan, Palanisamy [VerfasserIn]; Besselink, Marc G. [VerfasserIn]; Abu Hilal, Mohammed [VerfasserIn]; Qin, Renyi [VerfasserIn]

Minimally invasive versus open pancreatoduodenectomy for pancreatic ductal adenocarcinoma

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  • Medientyp: E-Artikel
  • Titel: Minimally invasive versus open pancreatoduodenectomy for pancreatic ductal adenocarcinoma : Individual patient data meta-analysis of randomized trials
  • Beteiligte: Uijterwijk, Bas [VerfasserIn]; Wei, Kongyuan [VerfasserIn]; Kasai, Meidai [VerfasserIn]; Ielpo, Benedetto [VerfasserIn]; Hilst, Jony van [VerfasserIn]; Chinnusamy, Palanivelu [VerfasserIn]; Lemmers, Daniel H. L. [VerfasserIn]; Burdio, Fernando [VerfasserIn]; Senthilnathan, Palanisamy [VerfasserIn]; Besselink, Marc G. [VerfasserIn]; Abu Hilal, Mohammed [VerfasserIn]; Qin, Renyi [VerfasserIn]
  • Erschienen: 10 August 2023
  • Erschienen in: European journal of surgical oncology ; 49(2023), 8, Seite 1351-1361
  • Sprache: Englisch
  • DOI: 10.1016/j.ejso.2023.03.227
  • ISSN: 1532-2157
  • Identifikator:
  • Schlagwörter: HPB surgery ; Minimally invasive pancreatoduodenectomy ; Minimally invasive surgery ; Open pancreatoduodenectomy ; Pancreatic ductal adenocarcinoma ; Pancreatoduodenectomy
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: Objective - Assessment of minimally invasive pancreatoduodenectomy (MIPD) in patients with pancreatic ductal adenocarcinoma (PDAC) is scarce and limited to non-randomized studies. This study aimed to compare oncological and surgical outcomes after MIPD compared to open pancreatoduodenectomy (OPD) for patients after resectable PDAC from published randomized controlled trials (RCTs). - Methods - A systematic review was performed to identify RCTs comparing MIPD and OPD including PDAC (Jan 2015-July 2021). Individual data of patients with PDAC were requested. Primary outcomes were R0 rate and lymph node yield. Secondary outcomes were blood-loss, operation time, major complications, hospital stay and 90-day mortality. - Results - Overall, 4 RCTs (all addressed laparoscopic MIPD) with 275 patients with PDAC were included. In total, 128 patients underwent laparoscopic MIPD and 147 patients underwent OPD. The R0 rate (risk difference(RD) −1%, P = 0.740) and lymph node yield (mean difference(MD) +1.55, P = 0.305) were comparable between laparoscopic MIPD and OPD. Laparoscopic MIPD was associated with less perioperative blood-loss (MD -91ml, P = 0.026), shorter length of hospital stay (MD -3.8 days, P = 0.044), while operation time was longer (MD +98.5 min, P = 0.003). Major complications (RD -11%, P = 0.302) and 90-day mortality (RD -2%, P = 0.328) were comparable between laparoscopic MIPD and OPD. - Conclusions - This individual patient data meta-analysis of MIPD versus OPD in patients with resectable PDAC suggests that laparoscopic MIPD is non-inferior regarding radicality, lymph node yield, major complications and 90-day mortality and is associated with less blood loss, shorter hospital stay, and longer operation time. The impact on long-term survival and recurrence should be studied in RCTs including robotic MIPD.
  • Zugangsstatus: Freier Zugang