Clinical Analysis Of Robotic Pancreatectomy With Vascular Reconstruction

Objective: Radical pancreatectomy with vascular reconstruction can improve the prognosis of patients.We try to evaluate the safety and feasibility of the robotic pancreatectomy with vascular reconstruction,and analyses the difference in clinical efficacy between the robot group and the open group.Methods:The data of 38 cases of pancreatectomy with vascular reconstruction in our center from January 2016 to December 2017 were retrospectively analyzed.15 patients underwent robotic pancreatectomy with vascular reconstruction,and the others underwent open surgery.The preoperative data includes age,gender,basic disease,ASA score and the intraoperative data includes operation time,blood loss,blood transfusion,vascular blocking time,pathology,positive margin,number of lymph nodes.Postoperative data included complications,extubation time,days of hospitalization,and follow-up data including tumor recurrence time,survival time.We use statistical software SPSS 22.0 for analysis and draw survival curves.Results: In robotic group,the mean operative time was 342.67 + 79.84 min,the mean blood loss was 573.33 + 310.45 ml,the mean blood transfusion volume was 433.33 + 301.58 ml,the mean postoperative hospital stay was 29.80 + 27.66 days,6(40%)patients had complications,2(13.33%)cases with pancreatic fistula,and 1(6.67%)patients reoperated again,without peri operative death.In open group,the mean operation time was 304.43±77.52 min,the mean intraoperative blood loss was 567.39±338.98 ml,the mean intraoperative blood transfusion was 656.52±476.57 ml,and the mean postoperative hospital stay was 28.56±16.55 days.10(43.49%%)patients had complications,4(17.39%)cases of pancreatic fistula,1(4.35%)patients reoperated,1(4.35%)patients died during the perioperative period.We draw the survival curve according to the results of the follow-up.The median survival time of the robot group was 26 + 1.57 months,and the median survival time of the open group was 15 + 3.74 months,P=0.087.The median tumor free survival time of the robotic group in the robot group was 26 + 13.77 months,and the median tumor free survival time of the open group was 17 + 2.25 months,P=0.179.Conclusion: There was no significant difference in operative time,intraoperative blood loss,blood transfusion volume,postoperative pancreatic fistula,bleeding,reoperation and perioperative mortality between the robot group and the open group.We believe that the robot vascular reconstruction is safe and feasible.There was no significant difference in survival time and tumor free survival time between the two groups.The results showed that the efficacy and prognosis of the robot group and the open group can achieve the same effect.