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最小的侵入性胰腺二切除术:随机对照临床试验的综合系统审查和元分析

Claudio Ricci¹, Vincenzo D'Ambra², Laura Alberici²

¹Department of Internal Medicine and Surgery (DIMEC), Alma Mater Studiorum, University of Bologna, Bologna, Italy. claudio.ricci6@unibo.it.

Annals of surgical oncology

|February 12, 2025

概括

最少侵入性胰腺双管切除术 (MIPD) 没有比开放性胰腺双管切除术 (OPD) 更优越,但提供了轻微的短期益处. 需要对MIPD进行进一步的研究.

科学领域:

手术瘤学手术瘤学
胃肠病学胃肠病学
最少侵入性的手术

背景情况:

至少侵入性 (MI) 与开放性胰腺二管切除术 (PD) 的比较有效性仍然不确定.
胰腺双管切除术是一种复杂的手术,伴有重大风险.

研究的目的:

系统地评估与开放性胰腺突切除术 (OPD) 相比,微创性胰腺突切除术 (MIPD) 的安全性和有效性.
分析主要结果,包括发病率,死亡率和R1切除率.

主要方法:

随机对照试验的系统审查和随机效应元分析.
包括7项涉及1428名患者的研究 (618名MIPD,711名OPD).
评估一次性 (发病率,死亡率,R1率) 和二次终点 (POPF,PPH,DGE,LOS,TFR等) 的评估. ) 的情况.

主要成果:

死亡率 (2.9%MIPD与2.6%OPD) 或重大发病率 (29.4%MIPD与25.6%OPD) 没有显著差异.
类似的R1切除率 (6.2%的MIPD与7%的OPD).
在MIPD和OPD之间,操作时间,并发症和恢复指标的可比结果.

结论:

最少侵入性胰腺双管切除术 (MIPD) 没有显示出高于开放性胰腺双管切除术 (OPD) 的优势.
MIPD可能会提供边际的短期优势.
需要进一步研究MIPD的学习曲线和经济可行性,特别是机器人方法.

关键词:

微创手术是最少的侵入性手术.疾病发病率疾病发病率死亡率死亡率死亡率胰腺二次切除术 (pancreatoduodenectomy) 是一个切除术.

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