Int J Med Robot - Robotic-assisted pancreatic resection: a report of 47 cases.

Tópicos

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Resumo

CKGROUND: There are few reports of robot-assisted pancreatic surgery. Our purpose was to report our surgical and clinical experiences and outcomes of 47 cases of robot-assisted pancreatic resection to show that minimally invasive pancreatic surgery is both feasible and effective.METHODS: The medical records of 47 patients who underwent robot-assisted pancreatic resections for adenocarcinoma, cystic tumours or other pancreatic diseases at our institution by a single surgical team from March 2010 to December 2011 were retrospectively analysed.RESULTS: There were 32 females and 15 males with a mean age of 48.7 ? 15.4 years, of whom 13 patients had pathologically diagnosed malignancies, 25 had cystic tumours or chronic pancreatitis, three had solid pseudopapillary tumours of pancreas, and six had other lesions. Sixteen patients underwent pancreatoduodenectomy, 16 distal pancreatectomies (nine of which had spleen resections), 10 middle pancreatectomies, four Beger's procedure, and one had enucleation of a pancreatic lesion. The mean surgical time was 299.2 ? 133.5 (range 70-540) min and mean blood loss was 431.8 ? 309.0 (range 50-1100) ml. Nine patients required a blood transfusion (mean transfusion volume 597.2 ? 543.3 ml). There were no conversions to laparotomy. The mean hospital stay was 29.4 ? 9.1 (range 8-41) days. Pancreatic fistula occurred in 20 cases, anastomotic bleeding in three patients and anastomotic leakage in one patient. Two patients, one who received a PD and one who received a distal pancreatectomy, required a second surgery. All other complications were resolved with conservative management. Surgical margins were negative in all cases, with a postoperative histopathological diagnosis of malignancy. Eleven of the 13 patients with malignancies were alive and well without recurrence at the time of publication, while two patients died.CONCLUSIONS: Our series of 47 robot-assisted pancreatic resections adds further evidence that this technique is feasible and effective.

Resumo Limpo

ckground report robotassist pancreat surgeri purpos report surgic clinic experi outcom case robotassist pancreat resect show minim invas pancreat surgeri feasibl effectivemethod medic record patient underw robotassist pancreat resect adenocarcinoma cystic tumour pancreat diseas institut singl surgic team march decemb retrospect analysedresult femal male mean age year patient patholog diagnos malign cystic tumour chronic pancreat three solid pseudopapillari tumour pancrea six lesion sixteen patient underw pancreatoduodenectomi distal pancreatectomi nine spleen resect middl pancreatectomi four beger procedur one enucl pancreat lesion mean surgic time rang min mean blood loss rang ml nine patient requir blood transfus mean transfus volum ml convers laparotomi mean hospit stay rang day pancreat fistula occur case anastomot bleed three patient anastomot leakag one patient two patient one receiv pd one receiv distal pancreatectomi requir second surgeri complic resolv conserv manag surgic margin negat case postop histopatholog diagnosi malign eleven patient malign aliv well without recurr time public two patient diedconclus seri robotassist pancreat resect add evid techniqu feasibl effect

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