Minimally Invasive versus Open Distal Pancreatectomy for Ductal Adenocarcinoma (DIPLOMA)

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van Hilst, JonyAcad Med Ctr, Netherlands (author)

Minimally Invasive versus Open Distal Pancreatectomy for Ductal Adenocarcinoma (DIPLOMA)

Article/chapterEnglish2019

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Lippincott Williams & Wilkins,2019
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LIBRIS-ID:oai:DiVA.org:liu-157572
https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-157572URI
https://doi.org/10.1097/SLA.0000000000002561DOI

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Language:English
Summary in:English

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

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Objective: The aim of this study was to compare oncological outcomes after minimally invasive distal pancreatectomy (MIDP) with open distal pancreatectomy (ODP) in patients with pancreatic ductal adenocarcinoma (PDAC).Background: Cohort studies have suggested superior short-term outcomes of MIDP vs. ODP. Recent international surveys, however, revealed that surgeons have concerns about the oncological outcomes of MIDP for PDAC.Methods: This is a pan-European propensity score matched study including patients who underwent MIDP (laparoscopic or robot-assisted) or ODP for PDAC between January 1, 2007 and July 1, 2015. MIDP patients were matched to ODP patients in a 1:1 ratio. Main outcomes were radical (R0) resection, lymph node retrieval, and survival.Results: In total, 1212 patients were included from 34 centers in 11 countries. Of 356 (29%) MIDP patients, 340 could be matched. After matching, the MIDP conversion rate was 19% (n = 62). Median blood loss [200 mL (60–400) vs 300 mL (150–500), P = 0.001] and hospital stay [8 (6–12) vs 9 (7–14) days, P < 0.001] were lower after MIDP. Clavien-Dindo grade ≥3 complications (18% vs 21%, P = 0.431) and 90-day mortality (2% vs 3%, P > 0.99) were comparable for MIDP and ODP, respectively. R0 resection rate was higher (67% vs 58%, P = 0.019), whereas Gerota's fascia resection (31% vs 60%, P < 0.001) and lymph node retrieval [14 (8–22) vs 22 (14–31), P< 0.001] were lower after MIDP. Median overall survival was 28 [95% confidence interval (CI), 22–34] versus 31 (95% CI, 26–36) months (P = 0.929).Conclusions: Comparable survival was seen after MIDP and ODP for PDAC, but the opposing differences in R0 resection rate, resection of Gerota's fascia, and lymph node retrieval strengthen the need for a randomized trial to confirm the oncological safety of MIDP.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kirurgi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Surgery hsv//eng
distal pancreatectomy; laparoscopic; left pancreatectomy; minimally invasive; robot-assisted

Added entries (persons, corporate bodies, meetings, titles ...)

de Rooij, ThijsAcad Med Ctr, Netherlands (author)
Klompmaker, SjorsAcad Med Ctr, Netherlands (author)
Rawashdeh, MajdSouthampton Univ Hosp NHS Fdn Trust, England (author)
Aleotti, FrancescaOsped San Raffaele, Italy (author)
Al-Sarireh, BilalMorriston Hosp, Wales (author)
Alseidi, AdnanVirginia Mason Med Ctr, WA 98101 USA (author)
Ateeb, ZeeshanKarolinska Inst, Sweden (author)
Balzano, GianpaoloOsped San Raffaele, Italy (author)
Berrevoet, FrederikGhent Univ Hosp, Belgium (author)
Björnsson, BergthorLinköpings universitet,Avdelningen för Kirurgi, Ortopedi och Onkologi,Medicinska fakulteten,Region Östergötland, Kirurgiska kliniken US(Swepub:liu)berbj34 (author)
Boggi, UgoUniv Pisa, Italy (author)
Busch, Olivier R.Acad Med Ctr, Netherlands (author)
Butturini, GiovanniPederzoli Hosp, Italy (author)
Casadei, RiccardoSt Orsola Marcello Malpighi Hosp, Italy (author)
Del Chiaro, MarcoKarolinska Inst, Sweden (author)
Chikhladze, SophiaUniv Klinikum Freiburg, Germany (author)
Cipriani, FedericaSouthampton Univ Hosp NHS Fdn Trust, England (author)
van Dam, RonaldMaastricht Univ, Netherlands (author)
Damoli, IsaccoVerona Univ Hosp, Italy (author)
van Dieren, SusanAcad Med Ctr, Netherlands (author)
Dokmak, SafiHosp Beaujon, France (author)
Edwin, BjornOslo Univ Hosp, Norway; Inst Clin Med, Norway (author)
van Eijck, CasperErasmus MC, Netherlands (author)
Fabre, Jean-MarieHop St Eloi, France (author)
Falconi, MassimoOsped San Raffaele, Italy (author)
Farges, OlivierHosp Beaujon, France (author)
Fernandez-Cruz, LaureanoHosp Clin Barcelona, Spain (author)
Forgione, AntonelloOsped Niguarda Ca Granda, Italy (author)
Frigerio, IsabellaPederzoli Hosp, Italy (author)
Fuks, DavidInst Mutualiste Montsouris, France (author)
Gavazzi, FrancescaHumanitas Univ Hosp, Italy (author)
Gayet, BriceInst Mutualiste Montsouris, France (author)
Giardino, AlessandroPederzoli Hosp, Italy (author)
Koerkamp, Bas GrootErasmus MC, Netherlands (author)
Hackert, ThiloHeidelberg Univ Hosp, Germany (author)
Hassenpflug, MatthiasHeidelberg Univ Hosp, Germany (author)
Kabir, IrfanOxford Univ Hosp NHS Fdn Trust, England (author)
Keck, TobiasUKSH Campus Lubeck, Germany (author)
Khatkov, IgorMoscow Clin Sci Ctr, Russia (author)
Kusar, MasaUniv Med Ctr Ljubljana, Slovenia (author)
Lombardo, CarloUniv Pisa, Italy (author)
Marchegiani, GiovanniVerona Univ Hosp, Italy (author)
Marshall, RyneVirginia Mason Med Ctr, WA 98101 USA (author)
Menon, Krish V.Kings Coll Hosp NHS Fdn Trust, England (author)
Montorsi, MarcoHumanitas Univ Hosp, Italy (author)
Orville, MarionHosp Beaujon, France (author)
de Pastena, MatteoVerona Univ Hosp, Italy (author)
Pietrabissa, AndreaUniv Hosp Pavia, Italy (author)
Poves, IgnaciHosp del Mar, Spain (author)
Primrose, JohnSouthampton Univ Hosp NHS Fdn Trust, England (author)
Pugliese, RaffaeleOsped Niguarda Ca Granda, Italy (author)
Ricci, ClaudioSt Orsola Marcello Malpighi Hosp, Italy (author)
Roberts, KeithUniv Hosp Birmingham, England (author)
Rosok, BardOslo Univ Hosp, Norway; Inst Clin Med, Norway (author)
Sahakyan, Mushegh A.Oslo Univ Hosp, Norway; Inst Clin Med, Norway (author)
Sanchez-Cabus, SantiagoHosp Clin Barcelona, Spain (author)
Sandström, PerLinköpings universitet,Avdelningen för Kirurgi, Ortopedi och Onkologi,Medicinska fakulteten,Region Östergötland, Kirurgiska kliniken US(Swepub:liu)persa07 (author)
Scovel, LaurenVirginia Mason Med Ctr, WA 98101 USA (author)
Solaini, LeonardoUniv Brescia, Italy (author)
Soonawalla, ZahirOxford Univ Hosp NHS Fdn Trust, England (author)
Souche, F. RegisHop St Eloi, France (author)
Sutcliffe, Robert P.UKSH Campus Lubeck, Germany; Univ Hosp Birmingham, England (author)
Tiberio, Guido A.Univ Brescia, Italy (author)
Tomazic, AlesUniv Med Ctr Ljubljana, Slovenia (author)
Troisi, RobertoGhent Univ Hosp, Belgium (author)
Wellner, UlrichHosp Clin Barcelona, Spain (author)
White, StevenFreeman Hosp Newcastle Upon Tyne, England (author)
Wittel, Uwe A.Univ Klinikum Freiburg, Germany (author)
Zerbi, AlessandroHumanitas Univ Hosp, Italy (author)
Bassi, ClaudioVerona Univ Hosp, Italy (author)
Besselink, Marc G.Academic Medical Centre, Amsterdam, The Netherlands (author)
Abu Hilal, MohammedSouthampton Univ Hosp NHS Fdn Trust, England (author)
Acad Med Ctr, NetherlandsSouthampton Univ Hosp NHS Fdn Trust, England (creator_code:org_t)

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In:Annals of Surgery: Lippincott Williams & Wilkins269:1, s. 10-170003-49321528-1140

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By the author/editor: van Hilst, Jony; de Rooij, Thijs; Klompmaker, Sjor ...; Rawashdeh, Majd; Aleotti, Frances ...; Al-Sarireh, Bila ...; show more...; Alseidi, Adnan; Ateeb, Zeeshan; Balzano, Gianpao ...; Berrevoet, Frede ...; Björnsson, Bergt ...; Boggi, Ugo; Busch, Olivier R ...; Butturini, Giova ...; Casadei, Riccard ...; Del Chiaro, Marc ...; Chikhladze, Soph ...; Cipriani, Federi ...; van Dam, Ronald; Damoli, Isacco; van Dieren, Susa ...; Dokmak, Safi; Edwin, Bjorn; van Eijck, Caspe ...; Fabre, Jean-Mari ...; Falconi, Massimo; Farges, Olivier; Fernandez-Cruz, ...; Forgione, Antone ...; Frigerio, Isabel ...; Fuks, David; Gavazzi, Frances ...; Gayet, Brice; Giardino, Alessa ...; Koerkamp, Bas Gr ...; Hackert, Thilo; Hassenpflug, Mat ...; Kabir, Irfan; Keck, Tobias; Khatkov, Igor; Kusar, Masa; Lombardo, Carlo; Marchegiani, Gio ...; Marshall, Ryne; Menon, Krish V.; Montorsi, Marco; Orville, Marion; de Pastena, Matt ...; Pietrabissa, And ...; Poves, Ignaci; Primrose, John; Pugliese, Raffae ...; Ricci, Claudio; Roberts, Keith; Rosok, Bard; Sahakyan, Musheg ...; Sanchez-Cabus, S ...; Sandström, Per; Scovel, Lauren; Solaini, Leonard ...; Soonawalla, Zahi ...; Souche, F. Regis; Sutcliffe, Rober ...; Tiberio, Guido A ...; Tomazic, Ales; Troisi, Roberto; Wellner, Ulrich; White, Steven; Wittel, Uwe A.; Zerbi, Alessandr ...; Bassi, Claudio; Besselink, Marc ...; Abu Hilal, Moham ...; show less...

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