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A comparison of minimally invasive vs open distal pancreatectomy for resectable pancreatic ductal adenocarcinoma: Propensity score matching analysis.

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Abstract
Background: Owing to concerns regarding adequate oncological outcomes and perioperative complications, minimally invasive distal pancreatectomy (MIDP) for pancreatic ductal adenocarcinoma (PDAC) has limited generalizability. The aim of this study was to assess the perioperative and oncologic outcomes of MIDP compared with open distal pancreatectomy (ODP) for resectable PDAC after propensity score matching (PSM).

Methods: The patients who underwent MIDP and ODP for PDAC between January 2010 and December 2017 were retrospectively reviewed. Demographics, perioperative outcomes, pathological outcomes, and overall and disease-free survival data were collected to compare MIDP and ODP. After PSM, perioperative and oncologic outcomes were analyzed.

Results: A total of 156 MIDP patients were compared with 156 ODP patients for resectable PDAC after PSM. Tumor size, TNM stage, differentiation, harvested lymph nodes, and positive lymph nodes were not different except for R1 resection and lymphovascular invasion between the MIDP and ODP groups. Operation times, overall complications, POPF, and adjuvant treatment were also not different between the two groups. The MIDP group had shorter hospital stays (10.0 vs 13.4 days, P < 0.001) and shorter interval times from surgery to adjuvant treatment (37.6 days vs 46.0 days, P = 0.002) than the ODP group. The MIDP group had better overall survival (34.9 vs 24.5 months, P = 0.012) and disease-free survival (16.2 vs 10.3 months, P = 0.001).

Conclusion: Minimally invasive distal pancreatectomy has advantages with respect to postoperative hospital stay, interval between surgery, and adjuvant treatment. MIDP is associated with the possibility of improved survival rate for resectable PDAC.
Author(s)
권재우박서영박예종전은성이우형송기병이재훈황대욱김송철
Issued Date
2021
Type
Article
Keyword
distal pancreatectomyminimal invasive surgerypancreatic cancer
DOI
10.1002/jhbp.853
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8319
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2454125950&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,A%20comparison%20of%20minimally%20invasive%20vs%20open%20distal%20pancreatectomy%20for%20resectable%20pancreatic%20ductal%20adenocarcinoma:%20Propensity%20score%20matching%20analysis.&amp;offset=0&amp;pcAvailability=true
Publisher
Journal of Hepato-Biliary-Pancreatic Sciences
Location
미국
Language
영어
ISSN
1868-6974
Citation Volume
28
Citation Number
11
Citation Start Page
967
Citation End Page
982
Appears in Collections:
Medicine > Medicine
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