Background: The primary treatment for pancreatic cancer is surgical resection, and laparoscopic resection offers benefits over open surgery. This study aimed to compare the short-term outcomes of robot-assisted vs. conventional laparoscopic distal pancreatectomy. Methods: Data of adults ≥ 20 years old with pancreatic cancer who underwent conventional laparoscopic or robot-assisted laparoscopic distal pancreatectomy were extracted from the United States (US) Nationwide Inpatient Sample (NIS) 2005–2018 database. Comorbidities and complications were identified through the International Classification of Diseases (ICD) codes. Short-term outcomes were compared using logistic regression and included length of hospital stay (LOS), perioperative complications, in-hospital mortality, unfavorable discharge, and total hospital costs. Results: A total of 886 patients were included; 27% received robot-assisted, and 73% received conventional laparoscopic surgery. The mean age of all patients was 65.3 years, and 52% were females. Multivariable analysis revealed that robot-assisted surgery was associated with a significantly reduced risk of perioperative complications (adjusted odds ratio (aOR) = 0.61, 95% confidence interval (CI): 0.45–0.83) compared to conventional laparoscopic surgery. Specifically, robot-assisted surgery was associated with a significantly decreased risk of VTE (aOR = 0.35, 95% CI: 0.14–0.83) and postoperative blood transfusion (aOR = 0.37, 95% CI: 0.23–0.61). Robot-assisted surgery was associated with a significantly shorter LOS (0.76 days shorter, 95% CI: −1.43–−0.09) but greater total hospital costs (18,284 USD greater, 95% CI: 4369.03–32,200.70) than conventional laparoscopic surgery. Conclusions: Despite the higher costs, robot-assisted distal pancreatectomy is associated with decreased risk of complications and shorter hospital stays than conventional laparoscopic distal pancreatectomy.
背景：胰腺癌的主要治疗手段为手术切除，腹腔镜切除术较开腹手术更具优势。本研究旨在比较机器人辅助与传统腹腔镜远端胰腺切除术的短期疗效。方法：从美国全国住院患者样本数据库（2005-2018年）中提取年龄≥20岁、接受传统腹腔镜或机器人辅助腹腔镜远端胰腺切除术的胰腺癌成人患者数据。通过国际疾病分类代码识别合并症及并发症。采用逻辑回归比较住院时间、围手术期并发症、院内死亡率、不良出院情况及住院总费用等短期结局指标。结果：共纳入886例患者，其中27%接受机器人辅助手术，73%接受传统腹腔镜手术。患者平均年龄65.3岁，女性占52%。多变量分析显示，与传统腹腔镜手术相比，机器人辅助手术可显著降低围手术期并发症风险（校正比值比=0.61，95%置信区间：0.45-0.83），特别是静脉血栓栓塞风险（校正比值比=0.35，95%置信区间：0.14-0.83）和术后输血风险（校正比值比=0.37，95%置信区间：0.23-0.61）。机器人辅助手术的住院时间显著缩短（减少0.76天，95%置信区间：-1.43至-0.09），但住院总费用更高（增加18,284美元，95%置信区间：4369.03-32,200.70）。结论：尽管费用较高，但与传统腹腔镜远端胰腺切除术相比，机器人辅助远端胰腺切除术可降低并发症风险并缩短住院时间。
肿瘤(癌症)患者之家