Comparison of Robot and open pancreaticodenectomy for the treatment primary duodenal adenocarcinoma

Abstract

Introduction: Robot surgery is a new method that maintains advantages and overcomes disadvantages of conventional methods, a surgical option for primary duodenal adenocarcinoma (PDA), is a complex procedure that has become increasing popular. However, there is no consensus as to whether this technique should be performed routinely. Our aim was to evaluate the outcomes of RPD compared with open pancreaticoduodenectomy (OPD). Method: Retrospective analysis of all pancreaticoduodenectomies at a single quaternary cancer referral center was performed, From January 2013 to March 2018, 50 RPDs were performed to treat PDA and were compared with 43 OPDs. Patients were also matched based on their demographic data and pathologic diagnosis. Demographic information, intraoperative and postoperative data, pathologic data, and follow-up evaluation data were collected at our center. And then compared using standard statistical methods. Result: The average follow-up time of all patients was 26.86 months (range 1.67 to 70.80 months). There were no significant differences in demography, short-term complications, pathological results or TNM staging between the two groups. The survival time of RPD group was slightly longer than that of OPD group (P=0.036). There were significant differences in oral time, blood loss time and hospital stay between the two groups (P < 0.05). However, there were no differences between the robotic group and the open group in terms of operation time, pancreatic texture, pancreatic anastomosis, vascular reconstruction, reoperation, 30-day readmission, chemotherapy, recurrence or R0 resection. Conclusion: This study found that RPD is a feasible, safe, and effective method for the treatment of PDA compared with OPD , may be a better preferred method for surgeons to choose for he treatment of PDA.