Robotic vs open distal pancreatectomy: A multi-institutional matched comparison analysis

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Pancreatic Surgery

Background:

• Pancreatic surgery, particularly distal pancreatectomy, remains challenging.
• Clinically relevant postoperative pancreatic fistula (CR-POPF) is a major cause of morbidity and mortality.
• Robotic distal pancreatectomy (RDP) and open distal pancreatectomy (ODP) are compared for CR-POPF and oncologic outcomes.

Purpose of the Study:

• To compare the incidence of CR-POPF between RDP and ODP.
• To evaluate the oncologic efficacy of RDP in patients with pancreatic ductal adenocarcinoma (PDAC).

Main Methods:

• A matched comparison analysis of 246 patients (82 RDP, 164 ODP) from five high-volume centers.
• Patients were matched by age, ASA score, BMI, pathology, and TNM staging.
• Short and long-term outcomes were compared between RDP and ODP groups.

Main Results:

• No significant difference in CR-POPF incidence was observed between RDP and ODP.
• In the PDAC subgroup, median disease-free survival (DFS) and overall survival (OS) were comparable between ODP and RDP groups.

Conclusions:

• Robotic distal pancreatectomy (RDP) is a safe and effective surgical option for PDAC.
• RDP demonstrates equivalent oncologic efficacy and CR-POPF rates compared to ODP in high-volume centers.