PDF(Pubmed)
Abstract：
UNASSIGNED: Advancements in surgical techniques have improved outcomes in patients undergoing pancreatic surgery. To date there have been no meta-analyses comparing robotic and laparoscopic approaches for distal pancreatectomies (DP) in patients with pancreatic adenocarcinoma (PDAC). This systematic review and network meta-analysis aims to explore the oncological outcomes of laparoscopic distal pancreatectomy (LDP), robotic distal pancreatectomy (RDP) and open distal pancreatectomy (ODP).
UNASSIGNED: A systematic search was conducted for studies reporting laparoscopic, robotic or open surgery for DP. Frequentist network meta-analysis of oncological outcomes (overall survival, resection margins, tumor recurrence, examined lymph nodes, administration of adjuvant therapy) were performed.
UNASSIGNED: Fifteen studies totalling 9,301 patients were included in the network meta-analysis. 1,946, 605 and 6,750 patients underwent LDP, RDP and ODP respectively. LDP (HR: 0.761, 95% CI: 0.642-0.901, p = 0.002) and RDP (HR: 0.757, 95% CI: 0.617-0.928, p = 0.008) were associated with overall survival (OS) benefit when compared to ODP. LDP (HR: 1.00, 95% CI: 0.793-1.27, p = 0.968) was not associated with OS benefit when compared to RDP. There were no significant differences between LDP, RDP and ODP for resection margins, tumor recurrence, examined lymph nodes and administration of adjuvant therapy.
UNASSIGNED: This study highlights the longer OS in both LDP and RDP when compared to ODP for patients with PDAC.
UNASSIGNED: https://www.crd.york.ac.uk/, PROSPERO (CRD42022336417).
UNASSIGNED: A systematic search was conducted for studies reporting laparoscopic, robotic or open surgery for DP. Frequentist network meta-analysis of oncological outcomes (overall survival, resection margins, tumor recurrence, examined lymph nodes, administration of adjuvant therapy) were performed.
UNASSIGNED: Fifteen studies totalling 9,301 patients were included in the network meta-analysis. 1,946, 605 and 6,750 patients underwent LDP, RDP and ODP respectively. LDP (HR: 0.761, 95% CI: 0.642-0.901, p = 0.002) and RDP (HR: 0.757, 95% CI: 0.617-0.928, p = 0.008) were associated with overall survival (OS) benefit when compared to ODP. LDP (HR: 1.00, 95% CI: 0.793-1.27, p = 0.968) was not associated with OS benefit when compared to RDP. There were no significant differences between LDP, RDP and ODP for resection margins, tumor recurrence, examined lymph nodes and administration of adjuvant therapy.
UNASSIGNED: This study highlights the longer OS in both LDP and RDP when compared to ODP for patients with PDAC.
UNASSIGNED: https://www.crd.york.ac.uk/, PROSPERO (CRD42022336417).
摘要：
■手术技术的进步改善了接受胰腺手术的患者的预后。迄今为止，尚无荟萃分析比较机器人和腹腔镜方法在胰腺腺癌（PDAC）患者中的远端胰腺切除术（DP）。本系统评价和网络荟萃分析旨在探讨腹腔镜远端胰腺切除术（LDP）的肿瘤学结果，机器人远端胰腺切除术（RDP）和开放式远端胰腺切除术（ODP）。
■对报告腹腔镜的研究进行了系统搜索，DP的机器人或开放式手术。肿瘤学结果的频繁网络荟萃分析(总生存率，切除边缘,肿瘤复发,检查淋巴结，给予辅助治疗)。
■15项研究共9,301名患者纳入网络荟萃分析。1,946、605和6,750名患者接受了LDP，分别为RDP和ODP。与ODP相比，LDP（HR：0.761，95％CI：0.642-0.901，p=0.002）和RDP（HR：0.757，95％CI：0.617-0.928，p=0.008）与总生存期（OS）获益相关。与RDP相比，LDP（HR：1.00，95％CI：0.793-1.27，p=0.968）与OS获益无关。LDP之间没有显着差异，切除边缘的RDP和ODP，肿瘤复发,检查淋巴结并给予辅助治疗。
■本研究强调了与PDAC患者的ODP相比，LDP和RDP的OS更长。
■https://www.crd.约克。AC.英国/,PROSPERO（CRD4202236417）。
■对报告腹腔镜的研究进行了系统搜索，DP的机器人或开放式手术。肿瘤学结果的频繁网络荟萃分析(总生存率，切除边缘,肿瘤复发,检查淋巴结，给予辅助治疗)。
■15项研究共9,301名患者纳入网络荟萃分析。1,946、605和6,750名患者接受了LDP，分别为RDP和ODP。与ODP相比，LDP（HR：0.761，95％CI：0.642-0.901，p=0.002）和RDP（HR：0.757，95％CI：0.617-0.928，p=0.008）与总生存期（OS）获益相关。与RDP相比，LDP（HR：1.00，95％CI：0.793-1.27，p=0.968）与OS获益无关。LDP之间没有显着差异，切除边缘的RDP和ODP，肿瘤复发,检查淋巴结并给予辅助治疗。
■本研究强调了与PDAC患者的ODP相比，LDP和RDP的OS更长。
■https://www.crd.约克。AC.英国/,PROSPERO（CRD4202236417）。
