Robotic and open distal pancreatectomy with celiac axis resection for locally advanced pancreatic body tumors: a single institutional assessment of perioperative outcomes and survival

Lee M. Ocuin, Jennifer L. Miller-Ocuin, Stephanie M. Novak, David L. Bartlett, J. Wallis Marsh, Allan Tsung, Kenneth K. Lee, Melissa E. Hogg, Herbert J. Zeh, Amer H. Zureikat

Research output: Contribution to journalArticle

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Abstract

Background Distal pancreatectomy with celiac axis resection (DP-CAR) is an option for T4 tumors of the pancreatic body. We examined the perioperative and oncologic outcomes of open and robotic DP-CAR at a high-volume pancreatic center. Methods Retrospective review of all consecutive DP-CARs. Patient demographics, 90-day perioperative outcomes, and disease specific survival were collected. Results 30 DP-CARs were performed (11 Robotic, 19 Open). Both groups had similar preoperative/tumor characteristics, and 27 of 28 PDA patients received neoadjuvant chemotherapy. Robotic DP-CAR was associated with decreased OT (316 vs. 476 min), reduced EBL (393 vs. 1736 ml) and lower rates of blood transfusion (0% vs. 54%) (all p < 0.05). No robotic DP-CAR required conversion. Both groups had similar rates of 90-day mortality, major morbidity, LOS, readmission, and receipt of adjuvant therapy. Similarly, both approaches were associated with high R0 resection rates (82% vs. 79%). At a median follow-up of 33 months, median overall survival for the PDA cohort was 35 months, with no difference in the robotic and open approach (33 and 40 months, p = 0.310). Conclusions With a median survival approaching 3 years, DP-CAR represents an effective treatment for select patients with locally advanced pancreatic body cancer, regardless of approach.

Original languageEnglish (US)
Pages (from-to)835-842
Number of pages8
JournalHPB
Volume18
Issue number10
DOIs
StatePublished - Oct 1 2016
Externally publishedYes

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Pancreatectomy
Robotics
Abdomen
Outcome Assessment (Health Care)
Survival
Neoplasms
Pancreatic Neoplasms
Blood Transfusion
Demography
Morbidity
Drug Therapy
Mortality
Therapeutics

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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Robotic and open distal pancreatectomy with celiac axis resection for locally advanced pancreatic body tumors : a single institutional assessment of perioperative outcomes and survival. / Ocuin, Lee M.; Miller-Ocuin, Jennifer L.; Novak, Stephanie M.; Bartlett, David L.; Marsh, J. Wallis; Tsung, Allan; Lee, Kenneth K.; Hogg, Melissa E.; Zeh, Herbert J.; Zureikat, Amer H.

In: HPB, Vol. 18, No. 10, 01.10.2016, p. 835-842.

Research output: Contribution to journalArticle

Ocuin, Lee M. ; Miller-Ocuin, Jennifer L. ; Novak, Stephanie M. ; Bartlett, David L. ; Marsh, J. Wallis ; Tsung, Allan ; Lee, Kenneth K. ; Hogg, Melissa E. ; Zeh, Herbert J. ; Zureikat, Amer H. / Robotic and open distal pancreatectomy with celiac axis resection for locally advanced pancreatic body tumors : a single institutional assessment of perioperative outcomes and survival. In: HPB. 2016 ; Vol. 18, No. 10. pp. 835-842.
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abstract = "Background Distal pancreatectomy with celiac axis resection (DP-CAR) is an option for T4 tumors of the pancreatic body. We examined the perioperative and oncologic outcomes of open and robotic DP-CAR at a high-volume pancreatic center. Methods Retrospective review of all consecutive DP-CARs. Patient demographics, 90-day perioperative outcomes, and disease specific survival were collected. Results 30 DP-CARs were performed (11 Robotic, 19 Open). Both groups had similar preoperative/tumor characteristics, and 27 of 28 PDA patients received neoadjuvant chemotherapy. Robotic DP-CAR was associated with decreased OT (316 vs. 476 min), reduced EBL (393 vs. 1736 ml) and lower rates of blood transfusion (0{\%} vs. 54{\%}) (all p < 0.05). No robotic DP-CAR required conversion. Both groups had similar rates of 90-day mortality, major morbidity, LOS, readmission, and receipt of adjuvant therapy. Similarly, both approaches were associated with high R0 resection rates (82{\%} vs. 79{\%}). At a median follow-up of 33 months, median overall survival for the PDA cohort was 35 months, with no difference in the robotic and open approach (33 and 40 months, p = 0.310). Conclusions With a median survival approaching 3 years, DP-CAR represents an effective treatment for select patients with locally advanced pancreatic body cancer, regardless of approach.",
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AU - Novak, Stephanie M.

AU - Bartlett, David L.

AU - Marsh, J. Wallis

AU - Tsung, Allan

AU - Lee, Kenneth K.

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AU - Zeh, Herbert J.

AU - Zureikat, Amer H.

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N2 - Background Distal pancreatectomy with celiac axis resection (DP-CAR) is an option for T4 tumors of the pancreatic body. We examined the perioperative and oncologic outcomes of open and robotic DP-CAR at a high-volume pancreatic center. Methods Retrospective review of all consecutive DP-CARs. Patient demographics, 90-day perioperative outcomes, and disease specific survival were collected. Results 30 DP-CARs were performed (11 Robotic, 19 Open). Both groups had similar preoperative/tumor characteristics, and 27 of 28 PDA patients received neoadjuvant chemotherapy. Robotic DP-CAR was associated with decreased OT (316 vs. 476 min), reduced EBL (393 vs. 1736 ml) and lower rates of blood transfusion (0% vs. 54%) (all p < 0.05). No robotic DP-CAR required conversion. Both groups had similar rates of 90-day mortality, major morbidity, LOS, readmission, and receipt of adjuvant therapy. Similarly, both approaches were associated with high R0 resection rates (82% vs. 79%). At a median follow-up of 33 months, median overall survival for the PDA cohort was 35 months, with no difference in the robotic and open approach (33 and 40 months, p = 0.310). Conclusions With a median survival approaching 3 years, DP-CAR represents an effective treatment for select patients with locally advanced pancreatic body cancer, regardless of approach.

AB - Background Distal pancreatectomy with celiac axis resection (DP-CAR) is an option for T4 tumors of the pancreatic body. We examined the perioperative and oncologic outcomes of open and robotic DP-CAR at a high-volume pancreatic center. Methods Retrospective review of all consecutive DP-CARs. Patient demographics, 90-day perioperative outcomes, and disease specific survival were collected. Results 30 DP-CARs were performed (11 Robotic, 19 Open). Both groups had similar preoperative/tumor characteristics, and 27 of 28 PDA patients received neoadjuvant chemotherapy. Robotic DP-CAR was associated with decreased OT (316 vs. 476 min), reduced EBL (393 vs. 1736 ml) and lower rates of blood transfusion (0% vs. 54%) (all p < 0.05). No robotic DP-CAR required conversion. Both groups had similar rates of 90-day mortality, major morbidity, LOS, readmission, and receipt of adjuvant therapy. Similarly, both approaches were associated with high R0 resection rates (82% vs. 79%). At a median follow-up of 33 months, median overall survival for the PDA cohort was 35 months, with no difference in the robotic and open approach (33 and 40 months, p = 0.310). Conclusions With a median survival approaching 3 years, DP-CAR represents an effective treatment for select patients with locally advanced pancreatic body cancer, regardless of approach.

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