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Robot-assisted laparoscopic versus open middle pancreatectomy: short-term results of a randomized controlled trial

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Abstract

Objective

This first prospective randomized controlled trial was performed to compare short-term outcomes of robot-assisted laparoscopic middle pancreatectomy (RA-MP) with open middle pancreatectomy (OMP).

Background

RA-MP is a novel minimally invasive surgical technique for benign or borderline tumors in the pancreatic neck or body. Its short-term effectiveness and safety remain unknown, compared to OMP.

Methods

Patients eligible for MP from August 2011 to November 2015 were randomized into the RA-MP or OMP group. The primary endpoint was length of hospital stay (LOS). Secondary endpoints were intraoperative parameters, and postoperative and recovery variables.

Results

A total of 100 patients were included into the study to analyze primary and secondary endpoints. Demographic characteristics and pathological parameters were similar in both groups. Furthermore, LOS was significantly shorter (15.6 vs. 21.7 days, P = 0.002), median operative time was reduced (160 vs. 193 min, P = 0.002), median blood loss was lower (50 vs. 200 mL, P < 0.001), rate of clinical postoperative pancreatic fistula (POPF) was lower (18 vs. 36.0 %, P = 0.043), nutritional status recovery was better, off-bed return to activity was expedited (3.1 vs. 4.6 days, P < 0.001), and resumption of bowel movement was faster (3.5 vs. 5.0 days, P < 0.001) in the RA-MP group, compared to the OMP group.

Conclusion

RA-MP was associated with significantly shorter LOS, reduced operative time, blood loss and clinical POPF rate, and expedited postoperative recovery, compared to OMP.

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Acknowledgments

The authors thank all of the participating patients and their families, as well as investigators, research nurses, study coordinators, and operation staff. Shi Chen and Qian Zhan contributed equally to this work, and both should be considered as first author. Bai-yong Shen and Cheng-hong Peng also contributed equally, and both should be considered as co-corresponding author.

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    Authors and Affiliations

    1. Department of General Surgery, Research Institute of Pancreatic Disease, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, People’s Republic of China

      Shi Chen, Qian Zhan, Jia-bin Jin, Zhi-chong Wu, Yuan Shi, Dong-feng Cheng, Hao Chen, Xia-xing Deng, Bai-yong Shen, Cheng-hong Peng & Hong-wei Li

    2. Department of Hepatobiliary Surgery, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, People’s Republic of China

      Shi Chen

    3. Shanghai Institute of Digestive Surgery, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, People’s Republic of China

      Qian Zhan, Jia-bin Jin, Zhi-chong Wu, Yuan Shi, Dong-feng Cheng, Hao Chen, Xia-xing Deng, Bai-yong Shen, Cheng-hong Peng & Hong-wei Li

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    1. Shi Chen
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    Correspondence to Bai-yong Shen or Cheng-hong Peng.

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    Disclosures

    Shi Chen, Qian Zhan, Jia-bin Jin, Zhi-chong Wu, Yuan Shi, Dong-feng Cheng, Hao Chen, Xia-xing Deng, Bai-yong Shen, Cheng-hong Peng, and Hong-wei Li have no conflicts of interest or financial ties to disclose.

    Additional information

    Shi Chen and Qian Zhan contributed equally to this work, and both should be considered as first author.

    Bai-yong Shen and Cheng-hong Peng also contributed equally, and both should be considered as co-corresponding author.

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    Chen, S., Zhan, Q., Jin, Jb. et al. Robot-assisted laparoscopic versus open middle pancreatectomy: short-term results of a randomized controlled trial. Surg Endosc 31, 962–971 (2017). https://doi.org/10.1007/s00464-016-5046-z

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