Which one is better? Laparoscopic versus robotic reconstruction in the remnant soft pancreas with a small pancreatic duct following pancreaticoduodenectomy: a multicenter study with propensity score matching analysis

Jang, Jae Young; Kang, Chang Moo; Kim, Hye-Yeon; Choi, Munseok; Lee, Jae Hoon; Choi, Sung Hoon

doi:10.1007/s00464-022-09602-2

Cited by 6 publications

(5 citation statements)

References 44 publications

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“…After screening the titles and abstracts, 592 articles that did not meet the inclusion criteria were excluded, leaving 169 articles. After reading the complete text, applying inclusion/exclusion criteria, and assessing data integrity, a total of 18 articles were included, comprising 5985 patients (2553 in the RPD group and 3432 in the LPD group, respectively) 14‐31 . The literature screening process is shown in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…After reading the complete text, applying inclusion/exclusion criteria, and assessing data integrity, a total of 18 articles were included, comprising 5985 patients (2553 in the RPD group and 3432 in the LPD group, respectively). [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] The literature screening process is shown in Figure 1. Finally, all included studies were of high quality, and their basic characteristics are presented in Table 1.…”

Section: Study Selection and Quality Assessmentmentioning

confidence: 99%

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Effect of laparoscopic pancreaticoduodenectomy on the incidence of surgical‐site wound infection: A meta‐analysis

Kong

Zhang

Zhao

et al. 2023

International Wound Journal

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A meta‐analysis was conducted to assess the impact of robotic and laparoscopic pancreaticoduodenectomies on postoperative surgical site wound infections. A comprehensive computerised search of databases, such as PubMed, EMBASE, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, and Wanfang Data, was performed to identify studies comparing robotic pancreaticoduodenectomy (PD) with laparoscopicPD. Relevant studies were searched from the inception of the database construction until April 2023. The meta‐analysis outcomes were analysed using odds ratios (OR) with corresponding 95% confidence intervals (CI). The RevMan 5.4 software was used for the meta‐analysis. The findings of the meta‐analysis showed that patients who underwent laparoscopic PD had a significantly lower incidence of surgical‐site wound (16.52% vs. 18.92%, OR: 0.78, 95% CI: 0.68–0.90, P = .0005), superficial wound (3.65% vs. 7.57%, OR: 0.51, 95% CI: 0.39–0.68, P < .001), and deep wound infections (1.09% vs. 2.23%, OR: 0.53, 95% CI: 0.34–0.85, P = .008) than those who received robotic PD. However, because of variations in sample size between studies, some studies suffered from methodological quality deficiencies. Therefore, further validation of this result is needed in future studies with higher quality and larger sample sizes.

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Section: Resultsmentioning

confidence: 99%

Section: Study Selection and Quality Assessmentmentioning

confidence: 99%

Effect of laparoscopic pancreaticoduodenectomy on the incidence of surgical‐site wound infection: A meta‐analysis

Kong

Zhang

Zhao

et al. 2023

International Wound Journal

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“…12,33,34 Moreover, in focusing on the reconstruction phase, some data showed that the reconstruction platform (robotic vs. laparoscopic) did not affect the clinical outcomes. 35 However, MIPD is a time-consuming procedure, and the early experience phase requires more operative time than the lateexperience phase. Some data suggest a reduction in musculoskeletal demands during robotic surgery because using a robotic platform might aid in overcoming the learning curve.…”

Section: Discussionmentioning

confidence: 99%

“…Although it was shown that a robotic platform reduces the learning curve compared to a laparoscopic platform, use of this platform is currently controversial 12,33,34 . Moreover, in focusing on the reconstruction phase, some data showed that the reconstruction platform (robotic vs. laparoscopic) did not affect the clinical outcomes 35 . However, MIPD is a time‐consuming procedure, and the early experience phase requires more operative time than the late‐experience phase.…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive pancreatoduodenectomy by junior surgeon: Initial experience of the next generation

Kim,

Hong,

Kang

2024

World j. surg.

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BackgroundSeveral guidelines exist for minimally invasive pancreatoduodenectomy (MIPD) regarding its prerequisites and learning curve. However, these guidelines are based on the experience of the pioneers of MIPD; minimal data exist on the experience of the next generation of surgeons. The aim of this study was to compare the two surgeon types (veteran and junior) for MIPD in terms of immediate postoperative outcomes.MethodsThe postoperative outcomes of 22 patients who underwent robot‐assisted pancreatoduodenectomy (RAPD) by a junior surgeon from July 2021 to December 2022 were retrospectively reviewed. The outcomes were compared with the initial postoperative outcomes and the contemporary postoperative outcomes of RAPD by a veteran surgeon.ResultsIn comparing the initial outcomes between the two surgeon types, the veteran surgeons showed a shorter operation time (junior surgeon vs. veteran surgeon: 606 ± 89 vs. 467 ± 77 min, p < 0.001). However, there was no significant difference in terms of postoperative outcomes, such as blood loss (300 [200–600] ml. vs. 200 [100–500] ml, p = 0.208), major complications (≥CDC IIIa: 4 (18.2%) vs. 4 (18.2%), p = 1.000), postoperative pancreatic fistula (POPF; ≥ISGPF Grade B: 2 (9.1%) vs. 3 (13.6%), p > 0.999), and length of hospital stay (18.0 ± 8.9 days vs. 18.3 ± 7.9 days, p = 0.915), between the two surgeon types. In addition, in a comparison of the contemporary outcomes, there was no significant difference in terms of postoperative outcome (complications: 4 (18.2%) vs 11 (11.1%), p = 0.580; POPF: 2 (9.1%) vs. 3 (3.0%), p = 0.484; length of hospital stay: 18.0 ± 8.9 vs. 15.0 ± 6.5 days, p = 0.065).ConclusionThe initial outcomes of MIPD by a well‐trained junior surgeon were found to be comparable to those of MIPD by a veteran surgeon.

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“…Many studies have shown that intraoperative blood transfusion will increase the risk of complications after PD. 9,10 If the above factors can be considered in this study, I think the conclusions of this study will play a more important role in clinical practice…”

Section: An Assessment Of Perioperative Outcomes For Open Laparoscopi...mentioning

confidence: 95%

An assessment of perioperative outcomes for open, laparoscopic, and robot‐assisted pancreaticoduodenectomy

Yang¹,

Zhu

2022

Journal of Surgical Oncology

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Which one is better? Laparoscopic versus robotic reconstruction in the remnant soft pancreas with a small pancreatic duct following pancreaticoduodenectomy: a multicenter study with propensity score matching analysis

Cited by 6 publications

References 44 publications

Effect of laparoscopic pancreaticoduodenectomy on the incidence of surgical‐site wound infection: A meta‐analysis

Effect of laparoscopic pancreaticoduodenectomy on the incidence of surgical‐site wound infection: A meta‐analysis

Minimally invasive pancreatoduodenectomy by junior surgeon: Initial experience of the next generation

An assessment of perioperative outcomes for open, laparoscopic, and robot‐assisted pancreaticoduodenectomy

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