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Comparative analysis of the perioperative and oncologic outcomes between RA-LDP and LDP

Ki Byung Song, PhD, Song Cheol Kim, PhD, Jaewoo Kwon, Seunghyun Hwang, Chung Hyeun Ma, Kwang-Min Park, Young-Joo Lee, Dae Wook Hwang, Jae Hoon Lee, Bong Jun Kwak, Seong-Ryong Kim, Sang Hyun Shin. Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Ulsan University College of Medicine and Asan Medical Center

Background: Robotic surgical systems provide motion stabilization by improved dexterity of wristed instruments, and magnified three-dimensional (3D) imaging. However, the effectiveness of this method remains uncertain in the era of distal pancreatectomy.

Aim: This study compared the perioperative and early oncologic outcomes between robot-assisted laparoscopic distal pancreatectomy (RA-LDP) and conventional laparoscopic distal pancreatectomy (LDP) performed by single surgeon.

Methods: The clinicopathologic features of 85 consecutive patients who underwent minimally-invasive distal pancreatectomy from October 2015 to August 2016 were retrospectively reviewed.

Results: Twenty six patients underwent RA-LDP and 59 had LDP. The median operative time was longer and procedures' cost was higher in RA-LDP group. There was increased frequency of spleen-preserving pancreatectomies in RA-LDP. There were no significant differences in operative blood loss, postoperative morbidity including pancreatic fistula, and postoperative hospital stay. There were no postoperative mortality. Compared with LDP for pancreatic cancer, RA-LDP had higher number of harvested lymph nodes and higher rate of R0 resection.

Conclusion: RA-LDP had similar perioperative outcomes compared with LDP. However, it was associated with high rate of spleen preservation. The oncological outcomes were superior for RA-LDP in terms of improved lymph node clearance and the rate of margin negative. RA-LDP can be safely adopted for left-sided pancreatic tumors by appropriate patient selection.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 80662

Program Number: P445

Presentation Session: Poster (Non CME)

Presentation Type: Poster

34

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