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最少侵入性与可切除新生体的开放性胰腺二切除术相比.

Nine de Graaf1,2,3, Anouk M L H Emmen1,2,3, Marco Ramera3,4

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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:

  • 至少侵入性胰腺突切除术 (MIPD) 可能为切除性胰腺瘤提供比开放性胰腺突切除术 (OPD) 更快的恢复.
  • 与OPD相比,MIPD的安全性和有效性仍在调查中.

研究的目的:

  • 为了确定MIPD是否在整体并发症方面与OPD无差.
  • 评估MIPD是否在功能恢复时间 (TTFR) 方面优于OPD.

主要方法:

  • 一项国际,多中心,患者盲目的随机非劣势性试验比较了机器人辅助/镜MIPD与OPD.
  • 288名患有可切除的胰腺或周瘤的患者被随机分配 (2:1比率).
  • 主要终点:90天内的整体并发症 (综合并发症指数);次要终点:TTFR.

主要成果:

  • MIPD不低于OPD (平均CCI为33.4比35.3,P=0.002) 的结果.
  • 在MIPD (7天) 和OPD (8天) 的中位数TTFR较短.
  • MIPD显示胰腺和手术部位感染率较低,但90天死亡率较高 (4.7%与2.0%相比).

结论:

  • 最少侵入性胰腺二切除术在切除性胰腺和周围瘤瘤患者的90天整体并发症方面不低于开放性胰腺二切除术.