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Robot-Assisted Middle Pancreatectomy for Elderly Patients: Our Initial Experience.

Zhang T, Wang X, Huo Z, Wen C, Wu Z, Jin J, Cheng D, Chen H, Deng X, Shen B, Peng C - Med. Sci. Monit. (2015)

Bottom Line: The mean hospital stay was 19.91 days.It had low risk of exocrine or endocrine dysfunction and benefited patients' long-term outcomes.Incidence of POPF was relatively high but we could prevent it from resulting in bad outcomes by scientific perioperative care and systemic treatment.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China (mainland).

ABSTRACT

Background: The aim of this study was to evaluate the indications, safety, feasibility, and short- and long-term outcomes for elderly patients who underwent robot-assisted middle pancreatectomies (MPs).

Material and methods: Ten patients (≥60 years) underwent robot-assisted middle pancreatectomies from 2012 to 2015. The perioperative data, including tumor size, operating time, rate of postoperative pancreatic fistula (POPF), postoperative morbidity, and other parameters, were analyzed. We collected and analyzed the follow-up information.

Results: The mean age of patients was 64.30 years (range, 60-73 years). The average tumor size was 2.61 cm. The 10 cases were all benign or low-grade malignant lesions. The mean operating time was 175.00 min. The mean blood loss was 113.00 ml with no blood transfusion needed. Postoperative fistulas developed in 5 patients; there were 2 Grade A fistulas and 3 grade B fistulas. There were 3 patients who underwent postoperative complications, including 2 Grade 1 or 2 complications and 1 Grade 3 complication. No reoperation and postoperative mortality occurred. The mean hospital stay was 19.91 days. After a median follow-up of 23 months, new onset of diabetes mellitus developed in 1 patient and none suffered from deterioration of previously diagnosed diabetes or exocrine insufficiency, and no tumor recurrence happened.

Conclusions: Robot-assisted middle pancreatectomy was safe and feasible for elderly people. It had low risk of exocrine or endocrine dysfunction and benefited patients' long-term outcomes. Incidence of POPF was relatively high but we could prevent it from resulting in bad outcomes by scientific perioperative care and systemic treatment.

No MeSH data available.


Related in: MedlinePlus

(A) Locations of trocars. C: camera port. R1: no. 1 machine arm. R2: no. 2 machine arm. R3: no. 3 machine arm. A: assistant port. (B) Typical tumor revealed by abdominal computed tomography. The arrow indicates the tumor.
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f1-medscimonit-21-2851: (A) Locations of trocars. C: camera port. R1: no. 1 machine arm. R2: no. 2 machine arm. R3: no. 3 machine arm. A: assistant port. (B) Typical tumor revealed by abdominal computed tomography. The arrow indicates the tumor.

Mentions: In our center, from Aug 2012 to May 2015, a total of 10 patients who underwent robot-assisted middle pancreatectomy were retrospectively evaluated (study group). The same major surgeon performed all the operations. The mean age of the robotic group was 64.30±4.95 years. The mean BMI was 21.20±2.35. There were 7 males and 3 females. The baseline demographic characteristics of the patients are shown in Table 1. Eight patients had no symptoms and the other 2 were diagnosed because of unresolved epigastric pain. All patients received ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), and other essential tests to locate the tumor and rule out surgery contradictions. All 10 lesions were located in the neck or proximal body of the pancreas (Figure 1B). The follow-up period was defined as the interval between the day of operation and the day of the last follow-up; the follow-up endpoint in this study was 1 May 2015. Outpatients were followed-up by telephone interviews. Exocrine deficiency was defined as steatorrhea or eating, combined with epigastrium pain and weight loss requiring pancreatic enzyme supplementation. Endocrine dysfunction means the postoperative new onset of Type 2 diabetes mellitus (T2DM) or worsening diabetes (defined as deterioration in the metabolic control of previously diagnosed diabetes, requiring modification of the medical treatment).


Robot-Assisted Middle Pancreatectomy for Elderly Patients: Our Initial Experience.

Zhang T, Wang X, Huo Z, Wen C, Wu Z, Jin J, Cheng D, Chen H, Deng X, Shen B, Peng C - Med. Sci. Monit. (2015)

(A) Locations of trocars. C: camera port. R1: no. 1 machine arm. R2: no. 2 machine arm. R3: no. 3 machine arm. A: assistant port. (B) Typical tumor revealed by abdominal computed tomography. The arrow indicates the tumor.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4588669&req=5

f1-medscimonit-21-2851: (A) Locations of trocars. C: camera port. R1: no. 1 machine arm. R2: no. 2 machine arm. R3: no. 3 machine arm. A: assistant port. (B) Typical tumor revealed by abdominal computed tomography. The arrow indicates the tumor.
Mentions: In our center, from Aug 2012 to May 2015, a total of 10 patients who underwent robot-assisted middle pancreatectomy were retrospectively evaluated (study group). The same major surgeon performed all the operations. The mean age of the robotic group was 64.30±4.95 years. The mean BMI was 21.20±2.35. There were 7 males and 3 females. The baseline demographic characteristics of the patients are shown in Table 1. Eight patients had no symptoms and the other 2 were diagnosed because of unresolved epigastric pain. All patients received ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), and other essential tests to locate the tumor and rule out surgery contradictions. All 10 lesions were located in the neck or proximal body of the pancreas (Figure 1B). The follow-up period was defined as the interval between the day of operation and the day of the last follow-up; the follow-up endpoint in this study was 1 May 2015. Outpatients were followed-up by telephone interviews. Exocrine deficiency was defined as steatorrhea or eating, combined with epigastrium pain and weight loss requiring pancreatic enzyme supplementation. Endocrine dysfunction means the postoperative new onset of Type 2 diabetes mellitus (T2DM) or worsening diabetes (defined as deterioration in the metabolic control of previously diagnosed diabetes, requiring modification of the medical treatment).

Bottom Line: The mean hospital stay was 19.91 days.It had low risk of exocrine or endocrine dysfunction and benefited patients' long-term outcomes.Incidence of POPF was relatively high but we could prevent it from resulting in bad outcomes by scientific perioperative care and systemic treatment.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China (mainland).

ABSTRACT

Background: The aim of this study was to evaluate the indications, safety, feasibility, and short- and long-term outcomes for elderly patients who underwent robot-assisted middle pancreatectomies (MPs).

Material and methods: Ten patients (≥60 years) underwent robot-assisted middle pancreatectomies from 2012 to 2015. The perioperative data, including tumor size, operating time, rate of postoperative pancreatic fistula (POPF), postoperative morbidity, and other parameters, were analyzed. We collected and analyzed the follow-up information.

Results: The mean age of patients was 64.30 years (range, 60-73 years). The average tumor size was 2.61 cm. The 10 cases were all benign or low-grade malignant lesions. The mean operating time was 175.00 min. The mean blood loss was 113.00 ml with no blood transfusion needed. Postoperative fistulas developed in 5 patients; there were 2 Grade A fistulas and 3 grade B fistulas. There were 3 patients who underwent postoperative complications, including 2 Grade 1 or 2 complications and 1 Grade 3 complication. No reoperation and postoperative mortality occurred. The mean hospital stay was 19.91 days. After a median follow-up of 23 months, new onset of diabetes mellitus developed in 1 patient and none suffered from deterioration of previously diagnosed diabetes or exocrine insufficiency, and no tumor recurrence happened.

Conclusions: Robot-assisted middle pancreatectomy was safe and feasible for elderly people. It had low risk of exocrine or endocrine dysfunction and benefited patients' long-term outcomes. Incidence of POPF was relatively high but we could prevent it from resulting in bad outcomes by scientific perioperative care and systemic treatment.

No MeSH data available.


Related in: MedlinePlus