Minimally invasive robot-assisted and laparoscopic distal pancreatectomy in a pan-European registry a retrospective cohort study

Background: International guidelines recommend monitoring the use and outcome of minimally invasive pancreatic surgery (MIPS). However, data from prospective international audits on minimally invasive distal pancreatectomy (MIDP) are lacking. This study examined the use and outcome of robot-assisted...

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Autores: van Bodegraven, EA, van Ramshorst, TME, Bratlie, SO, Kokkola, A, Sparrelid, E, Björnsson, B, Kleive, D, Burgdorf, SK, Dokmak, S, Koerkamp, BG, Cabús, SS, Molenaar, IQ, Boggi, U, Busch, OR, Petric, M, Roeyen, G, Hackert, T, Lips, DJ, D'Hondt, M, Coolsen, MME, Ferrari, G, Tingstedt, B, Serrablo, A, Gaujoux, S, Ramera, M, Khatkov, I, Ausania, F, Souche, R, Festen, S, Berrevoet, F, Keck, T, Sutcliffe, RP, Pando, E, de Wilde, RF, Aussilhou, B, Krohn, PS, Edwin, B, Sandström, P, Gilg, S, Seppänen, H, Vilhav, C, Abu Hilal, M, Besselink, MG
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p18208
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=18208
http://ddd.uab.cat/record/306947
Access Level:acceso abierto
Palabra clave:E-MIPS registry
laparoscopic distal pancreatectomy
minimally invasive distal pancreatectomy
registry-based outcome
robot-assisted distal pancreatectomy
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spelling Minimally invasive robot-assisted and laparoscopic distal pancreatectomy in a pan-European registry a retrospective cohort studyvan Bodegraven, EAvan Ramshorst, TMEBratlie, SOKokkola, ASparrelid, EBjörnsson, BKleive, DBurgdorf, SKDokmak, SKoerkamp, BGCabús, SSMolenaar, IQBoggi, UBusch, ORPetric, MRoeyen, GHackert, TLips, DJD'Hondt, MCoolsen, MMEFerrari, GTingstedt, BSerrablo, AGaujoux, SRamera, MKhatkov, IAusania, FSouche, RFesten, SBerrevoet, FKeck, TSutcliffe, RPPando, Ede Wilde, RFAussilhou, BKrohn, PSEdwin, BSandström, PGilg, SSeppänen, HVilhav, CAbu Hilal, MBesselink, MGE-MIPS registrylaparoscopic distal pancreatectomyminimally invasive distal pancreatectomyregistry-based outcomerobot-assisted distal pancreatectomyBackground: International guidelines recommend monitoring the use and outcome of minimally invasive pancreatic surgery (MIPS). However, data from prospective international audits on minimally invasive distal pancreatectomy (MIDP) are lacking. This study examined the use and outcome of robot-assisted (RDP) and laparoscopic (LDP) distal pancreatectomy in the E-MIPS registry. Patients and methods: Post-hoc analysis in a prospective audit on MIPS, including consecutive patients undergoing MIDP in 83 centers from 19 European countries (01-01-2019/31-12-2021). Primary outcomes included intraoperative events (grade 1: excessive blood loss, grade 2: conversion/change in operation, grade 3: intraoperative death), major morbidity, and in-hospital/30-day mortality. Multivariable logistic regression analyses identified high-risk groups for intraoperative events. RDP and LDP were compared in the total cohort and high-risk groups. Results: Overall, 1672 patients undergoing MIDP were included; 606 (36.2%) RDP and 1066 (63.8%) LDP. The annual use of RDP increased from 30.5% to 42.6% (P<0.001). RDP was associated with fewer grade 2 intraoperative events compared with LDP (9.6% vs. 16.8%, P<0.001), with longer operating time (238 vs. 201 min, P<0.001). No significant differences were observed between RDP and LDP regarding major morbidity (23.4% vs. 25.9%, P=0.264) and in-hospital/30-day mortality (0.3% vs. 0.8%, P=0.344). Three high-risk groups were identified; BMI greater than 25 kg/m(2), previous abdominal surgery, and vascular involvement. In each group, RDP was associated with fewer conversions and longer operative times. Conclusion: This European registry-based study demonstrated favorable outcomes for MIDP, with mortality rates below 1%. LDP remains the predominant approach, whereas the use of RDP is increasing. RDP was associated with fewer conversions and longer operative time, including in high-risk subgroups. Future randomized trials should confirm these findings and assess cost differences.Elsevier Ltd2024info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=18208http://ddd.uab.cat/record/306947International Journal of SurgeryISSN: 17439191ISSNe: 17439159reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Inglésinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p182082026-06-14T12:41:47Z
dc.title.none.fl_str_mv Minimally invasive robot-assisted and laparoscopic distal pancreatectomy in a pan-European registry a retrospective cohort study
title Minimally invasive robot-assisted and laparoscopic distal pancreatectomy in a pan-European registry a retrospective cohort study
spellingShingle Minimally invasive robot-assisted and laparoscopic distal pancreatectomy in a pan-European registry a retrospective cohort study
van Bodegraven, EA
E-MIPS registry
laparoscopic distal pancreatectomy
minimally invasive distal pancreatectomy
registry-based outcome
robot-assisted distal pancreatectomy
title_short Minimally invasive robot-assisted and laparoscopic distal pancreatectomy in a pan-European registry a retrospective cohort study
title_full Minimally invasive robot-assisted and laparoscopic distal pancreatectomy in a pan-European registry a retrospective cohort study
title_fullStr Minimally invasive robot-assisted and laparoscopic distal pancreatectomy in a pan-European registry a retrospective cohort study
title_full_unstemmed Minimally invasive robot-assisted and laparoscopic distal pancreatectomy in a pan-European registry a retrospective cohort study
title_sort Minimally invasive robot-assisted and laparoscopic distal pancreatectomy in a pan-European registry a retrospective cohort study
dc.creator.none.fl_str_mv van Bodegraven, EA
van Ramshorst, TME
Bratlie, SO
Kokkola, A
Sparrelid, E
Björnsson, B
Kleive, D
Burgdorf, SK
Dokmak, S
Koerkamp, BG
Cabús, SS
Molenaar, IQ
Boggi, U
Busch, OR
Petric, M
Roeyen, G
Hackert, T
Lips, DJ
D'Hondt, M
Coolsen, MME
Ferrari, G
Tingstedt, B
Serrablo, A
Gaujoux, S
Ramera, M
Khatkov, I
Ausania, F
Souche, R
Festen, S
Berrevoet, F
Keck, T
Sutcliffe, RP
Pando, E
de Wilde, RF
Aussilhou, B
Krohn, PS
Edwin, B
Sandström, P
Gilg, S
Seppänen, H
Vilhav, C
Abu Hilal, M
Besselink, MG
author van Bodegraven, EA
author_facet van Bodegraven, EA
van Ramshorst, TME
Bratlie, SO
Kokkola, A
Sparrelid, E
Björnsson, B
Kleive, D
Burgdorf, SK
Dokmak, S
Koerkamp, BG
Cabús, SS
Molenaar, IQ
Boggi, U
Busch, OR
Petric, M
Roeyen, G
Hackert, T
Lips, DJ
D'Hondt, M
Coolsen, MME
Ferrari, G
Tingstedt, B
Serrablo, A
Gaujoux, S
Ramera, M
Khatkov, I
Ausania, F
Souche, R
Festen, S
Berrevoet, F
Keck, T
Sutcliffe, RP
Pando, E
de Wilde, RF
Aussilhou, B
Krohn, PS
Edwin, B
Sandström, P
Gilg, S
Seppänen, H
Vilhav, C
Abu Hilal, M
Besselink, MG
author_role author
author2 van Ramshorst, TME
Bratlie, SO
Kokkola, A
Sparrelid, E
Björnsson, B
Kleive, D
Burgdorf, SK
Dokmak, S
Koerkamp, BG
Cabús, SS
Molenaar, IQ
Boggi, U
Busch, OR
Petric, M
Roeyen, G
Hackert, T
Lips, DJ
D'Hondt, M
Coolsen, MME
Ferrari, G
Tingstedt, B
Serrablo, A
Gaujoux, S
Ramera, M
Khatkov, I
Ausania, F
Souche, R
Festen, S
Berrevoet, F
Keck, T
Sutcliffe, RP
Pando, E
de Wilde, RF
Aussilhou, B
Krohn, PS
Edwin, B
Sandström, P
Gilg, S
Seppänen, H
Vilhav, C
Abu Hilal, M
Besselink, MG
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv E-MIPS registry
laparoscopic distal pancreatectomy
minimally invasive distal pancreatectomy
registry-based outcome
robot-assisted distal pancreatectomy
topic E-MIPS registry
laparoscopic distal pancreatectomy
minimally invasive distal pancreatectomy
registry-based outcome
robot-assisted distal pancreatectomy
description Background: International guidelines recommend monitoring the use and outcome of minimally invasive pancreatic surgery (MIPS). However, data from prospective international audits on minimally invasive distal pancreatectomy (MIDP) are lacking. This study examined the use and outcome of robot-assisted (RDP) and laparoscopic (LDP) distal pancreatectomy in the E-MIPS registry. Patients and methods: Post-hoc analysis in a prospective audit on MIPS, including consecutive patients undergoing MIDP in 83 centers from 19 European countries (01-01-2019/31-12-2021). Primary outcomes included intraoperative events (grade 1: excessive blood loss, grade 2: conversion/change in operation, grade 3: intraoperative death), major morbidity, and in-hospital/30-day mortality. Multivariable logistic regression analyses identified high-risk groups for intraoperative events. RDP and LDP were compared in the total cohort and high-risk groups. Results: Overall, 1672 patients undergoing MIDP were included; 606 (36.2%) RDP and 1066 (63.8%) LDP. The annual use of RDP increased from 30.5% to 42.6% (P<0.001). RDP was associated with fewer grade 2 intraoperative events compared with LDP (9.6% vs. 16.8%, P<0.001), with longer operating time (238 vs. 201 min, P<0.001). No significant differences were observed between RDP and LDP regarding major morbidity (23.4% vs. 25.9%, P=0.264) and in-hospital/30-day mortality (0.3% vs. 0.8%, P=0.344). Three high-risk groups were identified; BMI greater than 25 kg/m(2), previous abdominal surgery, and vascular involvement. In each group, RDP was associated with fewer conversions and longer operative times. Conclusion: This European registry-based study demonstrated favorable outcomes for MIDP, with mortality rates below 1%. LDP remains the predominant approach, whereas the use of RDP is increasing. RDP was associated with fewer conversions and longer operative time, including in high-risk subgroups. Future randomized trials should confirm these findings and assess cost differences.
publishDate 2024
dc.date.none.fl_str_mv 2024
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=18208
http://ddd.uab.cat/record/306947
url https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=18208
http://ddd.uab.cat/record/306947
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Elsevier Ltd
publisher.none.fl_str_mv Elsevier Ltd
dc.source.none.fl_str_mv International Journal of Surgery
ISSN: 17439191
ISSNe: 17439159
reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
instname_str Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
reponame_str r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
collection r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,198674

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