International Session（Symposium）6(JSGE・JGES・JSGS・JSGCS)
Fri. November 6th   9:00 - 12:00   Room 11: Portopia Hotel South Wing Topaz
IS-S6-7_G
 Robotic and open pancreatoduodenectomy on oncological feasibility and survival outcomes for pancreatic cancer
Yi-Ming Shyr
Taipei Veterans General Hospital
Objectives: This study is to clarify the feasibility and justification of robotic pancreaticoduodenectomy (RPD) on survival and oncological outcomes for pancreatic adenocarcinoma.
Summary background data:RPD working inside the abdominal cavity with a close and limited space raises the concerns of survival and oncological outcomes in the absence of randomized trials.
Methods: A propensity score-matched study comparing RPD and open pancreaticoduodenectomy (OPD) was conducted, based on 6 covariates commonly used to predict survival outcomes.
Results: A total of 130 patients with pancreatic adenocarcinoma were recruited after 1 : 1 propensity score-matching. RPD took longer operation time than OPD, with a median of 8.3 vs. 7.0 hours, P = 0.002. RPD was associated with less blood loss, lower overall surgical complication rate and lower incidence of delayed gastric emptying. Oncologically, radicality of resection was similar between RPD and OPD, and RPD harvested more lymph nodes, with a median lymph node yield of 18, vs. 16, P = 0.038. Before propensity score matching, survival outcome was better in RPD group than OPD, with 5-year survival of 27.0% vs. 17.6%, P = 0.006. After propensity score matching, there was still a trend towards improved overall survival in RPD although difference between RPD and OPD was not significant, with 5-year survival of 24.5% vs. 19.7%, P = 0.088.
Conclusion: RPD is not only feasible but also justified without increasing the surgical risk and with improved survival outcome. The survival and oncological outcomes by RPD is not inferior to OPD.
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