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250 Robotic Pancreatic Resections: Safety and Feasibility

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250 Robotic Pancreatic Resections: Safety and Feasibility

Auteurs : Amer H. Zureikat [États-Unis] ; A. James Moser [États-Unis] ; Brian A. Boone [États-Unis] ; David L. Bartlett [États-Unis] ; Mazen Zenati [États-Unis] ; Herbert J. Zeh [États-Unis]

Source :

Annals of surgery [ 0003-4932 ] ; 2013.

RBID : PMC:4619895

Abstract

Background and Objectives

Computer Assisted Robotic Surgery allows complex resections and anastomotic reconstructions to be performed with nearly identical standards to open surgery. We applied this technology to a variety of pancreatic resections to assess the safety, feasibility, versatility and reliability of this technology.

Methods

A retrospective review of a prospective database of robotic pancreatic resections at a single institution between August 2008 and November 2012 was performed. Peri-operative outcomes were analyzed.

Results

250 consecutive robotic pancreatic resections were analyzed; pancreaticoduodenectomy (PD =132), distal pancreatectomy (DP=83), central pancreatectomy (CP=13), pancreatic enucleation (10), total pancreatectomy (TP=5), Appleby resection (4), and Frey procedure (3). Thirty day and 90 day mortality was 0.8 % and 2.0%. Rate of Clavien 3 and 4 complications was 14 and 6 %. The ISGPF grade C fistula rate was 4%. Mean operative time for the two most common procedures was 529 ± 103 mins for PD, and 257 ± 93 mins for DP. Continuous improvement in operative times was observed over the course of the experience. Conversion to open procedure was required in 16 patients (6%);(11 PD, 2 DP, 2 CP, 1 TP) for failure to progress (14) and bleeding (2).

Conclusions

This represents to our knowledge the largest series of robotic pancreatic resections. Safety and feasibility metrics including the low incidence of conversion support the robustness of this platform and suggest no unanticipated risks inherent to this new technology. By defining these early outcome metrics this report begins to establish a framework for comparative effectiveness studies of this platform.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4619895

DOI: 10.1097/SLA.0b013e3182a4e87c
PubMed: 24002300
PubMed Central: 4619895

Affiliations:

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PMC:4619895

Le document en format XML

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<sec id="S2"><title>Methods</title>
<p id="P3">A retrospective review of a prospective database of robotic pancreatic resections at a single institution between August 2008 and November 2012 was performed. Peri-operative outcomes were analyzed.</p>
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<sec id="S3"><title>Results</title>
<p id="P4">250 consecutive robotic pancreatic resections were analyzed; pancreaticoduodenectomy (PD =132), distal pancreatectomy (DP=83), central pancreatectomy (CP=13), pancreatic enucleation (10), total pancreatectomy (TP=5), Appleby resection (4), and Frey procedure (3). Thirty day and 90 day mortality was 0.8 % and 2.0%. Rate of Clavien 3 and 4 complications was 14 and 6 %. The ISGPF grade C fistula rate was 4%. Mean operative time for the two most common procedures was 529 ± 103 mins for PD, and 257 ± 93 mins for DP. Continuous improvement in operative times was observed over the course of the experience. Conversion to open procedure was required in 16 patients (6%);(11 PD, 2 DP, 2 CP, 1 TP) for failure to progress (14) and bleeding (2).</p>
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250 Robotic Pancreatic Resections: Safety and Feasibility

250 Robotic Pancreatic Resections: Safety and Feasibility

Source :

Abstract

Links toward previous steps (curation, corpus...)

Links to Exploration step

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri

Pour générer des pages wiki