A review of the current evidence for the role of minimally invasive pancreatic surgery following neo-adjuvant chemotherapy  

作　　者：Francis P.Robertson Rowan W.Parks 

机构地区：[1]Department of Hepatobiliary and Transplant Surgery,Freeman Hospital,Newcastle,United Kingdom [2]Department of Clinical Surgery,Royal Infirmary of Edinburgh,Edinburgh,United Kingdom [3]Division of Surgical and Interventional Science,Royal Free Campus,University College London,London,United Kingdom

出　　处：《Laparoscopic, Endoscopic and Robotic Surgery》2022年第2期47-51,共5页腔镜、内镜与机器人外科（英文）

摘　　要：Objective:Surgical resection of pancreatic cancer remains the only potentially curative treatment for pancreatic ductal adenocarcinoma.The robotic platform has been introduced to surgical practice and recent large studies from national registries have demonstrated similar or improved peri-operative outcomes compared to the standard open approach.Neo-adjuvant chemotherapy is increasingly being offered to patients with borderline resectable/locally advanced disease but this has led to more challenging resections.Numbers of patients undergoing minimally invasive resection following neo-adjuvant chemotherapy remain low.The aim of this review is to assess the current evidence for the peri-operative safety and long-term oncological outcomes associated with minimally invasive pancreatic resection following neo-adjuvant chemotherapy.Methods:Medline,Embase and Cochrane Central Register for Clinical Trials were searched up until 31st October 2021.The search terms include“minimally invasive”,“robotic”,“laparoscopic”,“pancreatectomy”,“pancreatic resection”,“whipple's pancreaticoduodenectomy”,“distal pancreatectomy”,“chemotherapy”,“neo-adjuvant chemotherapy”,“radiotherapy”,“neo-adjuvant chemoradiotherapy”,“induction therapy”,and“conversion surgery”.All studies including patients undergoing pancreatic resections were included.Studies which did not clearly state the approach to resection(minimally invasive or open)were excluded.Results:Seventy-eight studies were identified of which 8 compared open and minimally invasive resection following neo-adjuvant chemotherapy.There was insufficient data to perform a meta-analysis.Robotic surgery was associated with lower blood loss and shorter length of hospital stay.Three-year overall survival rates were similar between patients who underwent robotic or open resection however the robotic approach was associated with higher lymph node yield and a lower R1 resection rate.Conclusion:Currently the evidence for minimally invasive surgery fol

关 键 词：Pancreatic resection Minimally invasive ROBOTIC Neo-adjuvant chemotherapy 

分 类 号：R73[医药卫生—肿瘤]