文章：

国际多中心胰腺左侧切除术研究（SIMPLR）：手术方式是否影响疗效？

Study International Multicentric Pancreatic Left Resections (SIMPLR): Does Surgical Approach Matter?

原文发布日期：5 March 2024

DOI: 10.3390/cancers16051051

类型: Article

开放获取: 是

英文摘要：

Background: Minimally invasive surgery is increasingly preferred for left-sided pancreatic resections. The SIMPLR study aims to compare open, laparoscopic, and robotic approaches using propensity score matching analysis. Methods: This study included 258 patients with tumors of the left side of the pancreas who underwent surgery between 2016 and 2020 at three high-volume centers. The patients were divided into three groups based on their surgical approach and matched in a 1:1 ratio. Results: The open group had significantly higher estimated blood loss (620 mL vs. 320 mL,p< 0.001), longer operative time (273 vs. 216 min,p= 0.003), and longer hospital stays (16.9 vs. 6.81 days,p< 0.001) compared to the laparoscopic group. There was no difference in lymph node yield or resection status. When comparing open and robotic groups, the robotic procedures yielded a higher number of lymph nodes (24.9 vs. 15.2,p= 0.011) without being significantly longer. The laparoscopic group had a shorter operative time (210 vs. 340 min,p< 0.001), shorter ICU stays (0.63 vs. 1.64 days,p< 0.001), and shorter hospital stays (6.61 vs. 11.8 days,p< 0.001) when compared to the robotic group. There was no difference in morbidity or mortality between the three techniques. Conclusion: The laparoscopic approach exhibits short-term benefits. The three techniques are equivalent in terms of oncological safety, morbidity, and mortality.

摘要翻译： 

背景：微创手术在左侧胰腺切除术中的应用日益受到青睐。SIMPLR研究旨在通过倾向评分匹配分析比较开腹、腹腔镜及机器人手术方式。 方法：本研究纳入2016至2020年间在三大高手术量中心接受手术的258例左侧胰腺肿瘤患者。根据手术方式将患者分为三组，并按1:1比例进行匹配。 结果：与腹腔镜组相比，开腹组术中估计失血量显著更高（620 mL vs. 320 mL，p<0.001）、手术时间更长（273分钟 vs. 216分钟，p=0.003）、住院时间更长（16.9天 vs. 6.81天，p<0.001）。两组在淋巴结清扫数目及切缘状态上无显著差异。开腹组与机器人组比较显示，机器人手术能获取更多淋巴结（24.9枚 vs. 15.2枚，p=0.011），而手术时间无显著延长。腹腔镜组相较于机器人组具有更短的手术时间（210分钟 vs. 340分钟，p<0.001）、更短的ICU停留时间（0.63天 vs. 1.64天，p<0.001）及更短的住院时间（6.61天 vs. 11.8天，p<0.001）。三种术式在并发症发生率及死亡率方面无统计学差异。 结论：腹腔镜手术具有短期获益优势。三种技术在肿瘤学安全性、并发症及死亡率方面效果相当。

原文链接：

Study International Multicentric Pancreatic Left Resections (SIMPLR): Does Surgical Approach Matter?