Gastroenterology > > Pancreatic Diseases– Shorter stays, faster surgical treatments, and less blood loss versus open surgical treatment in Chinese research study
by Mike Bassett, Staff Writer, MedPage Today February 29, 2024
Carried out by extremely skilled cosmetic surgeons, robot-assisted pancreatoduodenectomy for pancreatic head or periampullary growths showed practical and safe and revealed modest enhancements in short-term results compared to open surgical treatment, an open-label randomized trial in China discovered.
In the research study’s customized intent-to-treat population, robotic surgical treatment substantially lowered postoperative medical facility length of stay compared to open surgical treatment (typical 11 vs 13.5 days, P=0.029), according to Rong Liu, MD, PhD, of the First Medical Center of Chinese People’s Liberation Army General Hospital in Beijing, and associates.
In addition, robotic surgical treatment was connected with much shorter operating times (245 vs 298 minutes, P=0.0013) along with decreased blood loss (75 vs 150 mL, P< 0.0001), Liu and associates reported in Lancet Gastroenterology and Hematology
This is the very first multicenter, head-to-head trial revealing that robotic pancreatoduodenectomy can reduce length of stay over open pancreatoduodenectomy, the scientists kept in mind, including that postoperative length of stay “is not just a single indication, however a detailed representation of postoperative practical healing and medical advantage.”
The much shorter postoperative remain in the robotic pancreatoduodenectomy group “was not at the cost of increased readmission and death rates,” stated Liu and co-authors.
Over 90 days of follow-up, 6 of the 81 clients (7%) in the robotic-surgery group and 5 of the 80 clients (6%) in the open-surgery group needed readmission, consisting of for intra-abdominal hemorrhage (one in each group), throwing up (2 in the robotic surgical treatment group and one outdoors surgical treatment group), electrolyte disruption (one in each group), and fever (2 in each group).
The general occurrence of postoperative issues of grade 3 or greater was comparable in between groups (22% vs 23.4%, respectively), as was the 90-day death rate, with one in-hospital death in each group.
Pathology results in between groups were likewise comparable, according to Liu and coworkers, consisting of growth size, growth type, distinction, the variety of lymph nodes recovered, and favorable nodes.
In a commentary accompanying the research study, Elisa Bannone, MD, of Istituto Ospedaliero Fondazione Poliambulanza in Brescia, Italy, and Giovanni Marchegiani, MD, PhD, of the University of Padua in Italy, stated the trial “reveals that RPD [robotic pancreatoduodenectomy] is prepared for traditional usage by skilled clinicians and centers, verifying its comparable short-term results compared to OPD [open pancreatoduodenectomy] in picked cases.”
Bannone and Marchegiani warned that regardless of the equivalent pathology results, “we ought to acknowledge that the [randomized controlled trial] did not have the analytical power to define oncological results.”
“Subsequent examinations must provide concern to these results to robustly confirm the robotic method and professionals performing RPD ought to keep a thorough windows registry for precise result tracking,” they composed.
The randomized trial was performed at 3 high-volume healthcare facilities in China.