Laparoscopic versus open pancreaticoduodenectomy a systematic review and meta-analysis of randomized controlled trials

Nickel, Felix; Haney, Caelán Max; Probst, Pascal; Kowalewski, Karl‐Friedrich; Diener, MK; Limen, Eldridge Frederick; Strobel, Oliver; Müller-Stich, Beat-Peter; Hackert, Thilo

doi:10.1016/j.hpb.2020.04.299

Cited by 71 publications

(119 citation statements)

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“…A European randomized trial of minimally invasive vs ODP demonstrated advantages to the minimally invasive approach with reduced time to functional recovery, operative blood loss, and frequency of delayed gastric emptying when compared to open surgery (ODP) 25 . Trials of laparoscopic pancreaticoduodenectomy vs OPD, however, have shown mixed results with two trials (from Spain and India) suggesting advantages, while a third from the Netherlands, terminated early due to concerns over increased 90‐day mortality in the laparoscopic cohort (10% vs 2%; relative risk = 4.9; 95% CI: 0.59‐40.44; P = .20) 26 …”

Section: Discussionmentioning

confidence: 99%

Long‐term oncologic outcomes of robotic and open pancreatectomy in a national cohort of pancreatic adenocarcinoma

Nassour

Winters

Hoehn

et al. 2020

Journal of Surgical Oncology

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Background Robotic pancreatectomy is gaining momentum; however, limited data exist on the long‐term survival of this approach for pancreatic ductal adenocarcinoma (PDAC). The objective of this study is to compare the long‐term oncologic outcomes of robotic pancreaticoduodenectomy (RPD) and robotic distal pancreatectomy (RDP) to open surgery in patients with PDAC. Study Design Robotic and open pancreatectomy for stages I‐III PDAC were obtained from the 2010 to 2016 National Cancer Database. Results We identified 17 831 pancreaticoduodenectomies and 2718 distal pancreatectomies of which 626 (4%) and 332 (12%) were robotic, respectively. There was no difference in median overall survival between RPD (22.0 months) and open pancreatoduodenectomy (21.8 months; logrank P = .755). The adjusted hazard ratio [HR] was 1.014 (95% confidence interval [CI]: 0.903‐1.139). The median overall survival for RDP (35.3 months) was higher than open distal pancreatectomy (ODP) (24.9 months; logrank P = .001). The adjusted HR suggests a benefit to RDP compared to ODP (HR, 0.744; 95% CI: 0.632‐0.868) Conclusion In a national cohort of resected pancreatic adenocarcinoma, the robotic platform was associated with similar long‐term survival for pancreaticoduodenectomy, but improved survival for distal pancreatectomy.

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Section: Discussionmentioning

confidence: 99%

Long‐term oncologic outcomes of robotic and open pancreatectomy in a national cohort of pancreatic adenocarcinoma

Nassour

Winters

Hoehn

et al. 2020

Journal of Surgical Oncology

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“…For example, the recent Dutch Leopard-II study was terminated early due to increased mortality in the laparoscopic group [ 41 ]. A subsequent meta-analysis comparing open and laparoscopic pancreaticoduodenectomy including only RCTs did not find any relevant advantage which would support the use of laparoscopy for this procedure [ 42 , 43 ]. However, the robotic approach to pancreaticoduodenectomy seems to offer a promising alternative to the open procedure with comparable postoperative outcomes and low mortality and should thus be evaluated in RCTs [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Functional outcomes after laparoscopic versus robotic-assisted rectal resection: a systematic review and meta-analysis

et al. 2020

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Surgical resection is crucial for curative treatment of rectal cancer. Through multidisciplinary treatment, including radiochemotherapy and total mesorectal excision, survival has improved substantially. Consequently, more patients have to deal with side effects of treatment. The most recently introduced surgical technique is robotic-assisted surgery (RAS) which seems equally effective in terms of oncological control compared to laparoscopy. However, RAS enables further advantages which maximize the precision of surgery, thus providing better functional outcomes such as sexual function or contience without compromising oncological results. This review was done according to the PRISMA and AMSTAR-II guidelines and registered with PROSPERO (CRD42018104519). The search was planned with PICO criteria and conducted on Medline, Web of Science and CENTRAL. All screening steps were performed by two independent reviewers. Inclusion criteria were original, comparative studies for laparoscopy vs. RAS for rectal cancer and reporting of functional outcomes. Quality was assessed with the Newcastle-Ottawa scale. The search retrieved 9703 hits, of which 51 studies with 24,319 patients were included. There was a lower rate of urinary retention (non-RCTs: Odds ratio (OR) [95% Confidence Interval (CI)] 0.

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“…Furthermore, the incidence of PAAD is continuously increasing, and it is estimated that PAAD will become the second leading cause of cancer-associated mortality in the United States by 2030 (4). Pancreaticoduodenectomy is currently the only potentially curative therapeutic approach for PAAD (5,6). Most types of cancer can usually be cured at local stages by surgical resection (5,6).…”

Section: Introductionmentioning

confidence: 99%

“…Pancreaticoduodenectomy is currently the only potentially curative therapeutic approach for PAAD (5,6). Most types of cancer can usually be cured at local stages by surgical resection (5,6). However, resections of PAAD tumor usually fail to achieve long-term survival in most cases (5,6).…”

Section: Introductionmentioning

confidence: 99%

lncRNA IUR upregulates miR‑34a to inhibit pancreatic adenocarcinoma cell migratory and invasive abilities

Zhang

et al. 2021

Oncol Lett

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T he long non-coding R NA (lncR NA) imatinib-upregulated (IUR) has been recently reported as a tumor suppressor in leukemia. Preliminary microarray data revealed a downregulation of IUR in pancreatic adenocarcinoma (PAAD) and a positive correlation with microRNA-34a (miR-34a) expression. The present study aimed to investigate the role of IUR in PAAD. This study included samples from 58 patients with PAAD and the PAAD cell lines Capan-2 and HPAC. Reverse transcription quantitative PCR was performed to determine gene expression levels. Cell transfections were carried out to assess gene interactions between IUR, miR-34a and CD44. Transwell assays were performed to explore the effects of transfections on cell invasive and migratory abilities. The results demonstrated that IUR was downregulated in PAAD tissue compared with adjacent non-tumor tissue samples and that low expression levels of IUR correlated with poor survival in patients with PAAD. In PAAD tissue samples, the expression of IUR positively correlated with miR-34a expression but negatively correlated with CD44 expression, which is a target of miR-34a. In PAAD cells, overexpression of IUR resulted in miR-34a upregulation and CD44 downregulation. miR-34a overexpression did not affect the expression of IUR but downregulated CD44. In PAAD cells, overexpression of IUR and miR-34a led to decreased invasive and migratory abilities. However, CD44 overexpression played an opposite role and attenuated the effects of IUR and miR-34a overexpression. In conclusion, the results from this study demonstrated that IUR may upregulate miR-34a expression in order to inhibit PAAD cell migration and invasion by downregulating CD44.

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Laparoscopic versus open pancreaticoduodenectomy a systematic review and meta-analysis of randomized controlled trials

Cited by 71 publications

References 0 publications

Long‐term oncologic outcomes of robotic and open pancreatectomy in a national cohort of pancreatic adenocarcinoma

Long‐term oncologic outcomes of robotic and open pancreatectomy in a national cohort of pancreatic adenocarcinoma

Functional outcomes after laparoscopic versus robotic-assisted rectal resection: a systematic review and meta-analysis

lncRNA IUR upregulates miR‑34a to inhibit pancreatic adenocarcinoma cell migratory and invasive abilities

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