Einzeltreffer — DigiBib

Objective: To assess the nationwide long-term uptake and outcomes of minimally invasive distal pancreatectomy (MIDP) after a nationwide training program and randomized trial.

Background: Two randomized trials demonstrated the superiority of MIDP over open distal pancreatectomy (ODP) in terms of functional recovery and hospital stay. Data on implementation of MIDP on a nationwide level are lacking.

Methods: Nationwide audit-based study including consecutive patients after MIDP and ODP in 16 centers in the Dutch Pancreatic Cancer Audit (2014 to 2021). The cohort was divided into three periods: early implementation, during the LEOPARD randomized trial, and late implementation. Primary endpoints were MIDP implementation rate and textbook outcome.

Results: Overall, 1496 patients were included with 848 MIDP (56.5%) and 648 ODP (43.5%). From the early to the late implementation period, the use of MIDP increased from 48.6% to 63.0% and of robotic MIDP from 5.5% to 29.7% ( P <0.001). The overall use of MIDP (45% to 75%) and robotic MIDP (1% to 84%) varied widely between centers ( P <0.001). In the late implementation period, 5/16 centers performed >75% of procedures as MIDP. After MIDP, in-hospital mortality and textbook outcome remained stable over time. In the late implementation period, ODP was more often performed in ASA score III-IV (24.9% vs. 35.7%, P =0.001), pancreatic cancer (24.2% vs. 45.9%, P <0.001), vascular involvement (4.6% vs. 21.9%, P <0.001), and multivisceral involvement (10.5% vs. 25.3%, P <0.001). After MIDP, shorter hospital stay (median 7 vs. 8 d, P <0.001) and less blood loss (median 150 vs. 500 mL, P <0.001), but more grade B/C postoperative pancreatic fistula (24.4% vs. 17.2%, P =0.008) occurred as compared to ODP.

Conclusion: A sustained nationwide implementation of MIDP after a successful training program and randomized trial was obtained with satisfactory outcomes. Future studies should assess the considerable variation in the use of MIDP between centers and, especially, robotic MIDP.

Competing Interests: The authors report no conflicts of interest.

Titel:	Nationwide use and Outcome of Minimally Invasive Distal Pancreatectomy in IDEAL Stage IV following a Training Program and Randomized Trial.
Autor/in / Beteiligte Person:	Korrel, M ; van Hilst J ; Bosscha, K ; Busch, ORC ; Daams, F ; van Dam R ; van Eijck CHJ ; Festen, S ; Groot Koerkamp, B ; van der Harst E ; Lips, DJ ; Luyer, MD ; de Meijer VE ; Mieog, JSD ; Molenaar, IQ ; Patijn, GA ; van Santvoort HC ; van der Schelling GP ; Stommel, MWJ ; Besselink, MG
Zeitschrift:	Annals of surgery, Jg. 279 (2024-02-01), Heft 2, S. 323-330
Veröffentlichung:	Philadelphia, PA : Lippincott Williams & Wilkins, 2024
Medientyp:	academicJournal
ISSN:	1528-1140 (electronic)
DOI:	10.1097/SLA.0000000000005900
Schlagwort:	Humans Pancreatectomy methods Treatment Outcome Postoperative Complications etiology Length of Stay Retrospective Studies Robotic Surgical Procedures methods Laparoscopy methods Pancreatic Neoplasms surgery
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Corporate Authors: Dutch Pancreatic Cancer Group Publication Type: Randomized Controlled Trial; Journal Article Language: English [Ann Surg] 2024 Feb 01; Vol. 279 (2), pp. 323-330. <i>Date of Electronic Publication: </i>2023 May 04. MeSH Terms: Robotic Surgical Procedures* / methods ; Laparoscopy* / methods ; Pancreatic Neoplasms* / surgery ; Humans ; Pancreatectomy / methods ; Treatment Outcome ; Postoperative Complications / etiology ; Length of Stay ; Retrospective Studies References: Cuschieri A. Laparoscopic pancreatic resections. Semin Laparosc Surg. 1996;3:15–20. ; de Rooij T, Klompmaker S, Abu Hilal M, et al. Laparoscopic pancreatic surgery for benign and malignant disease. Nat Rev Gastroenterol Hepatol. 2016;13:227–238. ; Drymousis P, Raptis DA, Spalding D, et al. Laparoscopic versus open pancreas resection for pancreatic neuroendocrine tumours: a systematic review and meta-analysis. HPB (Oxford). 2014;16:397–406. ; Jin T, Altaf K, Xiong JJ, et al. A systematic review and meta-analysis of studies comparing laparoscopic and open distal pancreatectomy. HPB (Oxford). 2012;14:711–724. ; Jusoh AC, Ammori BJ. Laparoscopic versus open distal pancreatectomy: a systematic review of comparative studies. Surg Endosc. 2012;26:904–913. ; Nigri GR, Rosman AS, Petrucciani N, et al. Metaanalysis of trials comparing minimally invasive and open distal pancreatectomies. Surg Endosc. 2011;25:1642–1651. ; Venkat R, Edil BH, Schulick RD, et al. Laparoscopic distal pancreatectomy is associated with significantly less overall morbidity compared to the open technique: a systematic review and meta-analysis. Ann Surg. 2012;255:1048–1059. ; Rosok BI, de Rooij T, van Hilst J, et al. Minimally invasive distal pancreatectomy. HPB (Oxford). 2017;19:205–214. ; McCulloch P, Altman DG, Campbell WB, et al. No surgical innovation without evaluation: the IDEAL recommendations. Lancet. 2009;374:1105–1112. ; de Rooij T, Jilesen AP, Boerma D, et al. A nationwide comparison of laparoscopic and open distal pancreatectomy for benign and malignant disease. J Am Coll Surg. 2015;220:263–270 e1. ; de Rooij T, van Hilst J, Boerma D, et al. Impact of a nationwide training program in minimally invasive distal pancreatectomy (LAELAPS). Ann Surg. 2016;264:754–762. ; de Rooij T, van Hilst J, van Santvoort H, et al. Minimally invasive versus open distal pancreatectomy (LEOPARD): a multicenter patient-blinded randomized controlled trial. Ann Surg. 2019;269:2–9. ; Bjornsson B, Larsson AL, Hjalmarsson C, et al. Comparison of the duration of hospital stay after laparoscopic or open distal pancreatectomy: randomized controlled trial. Br J Surg. 2020;107:1281–1288. ; van Rijssen LB, Koerkamp BG, Zwart MJ, et al. Nationwide prospective audit of pancreatic surgery: design, accuracy, and outcomes of the Dutch Pancreatic Cancer Audit. HPB (Oxford). 2017;19:919–926. ; Strijker M, Mackay TM, Bonsing BA, et al. Establishing and coordinating a nationwide multidisciplinary study group: lessons learned by the dutch pancreatic cancer group. Ann Surg. 2020;271:e102–e104. ; von Elm E, Altman DG, Egger M, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Epidemiology. 2007;18:800–804. ; Cancer TiAfRo. WHO Classification of Tumours of the Digestive System 4th edition. 2010. ; van Roessel S, Mackay TM, van Dieren S, et al. Textbook outcome: nationwide analysis of a novel quality measure in pancreatic surgery. Ann Surg. 2020;271:155–162. ; Clavien PA, Sanabria JR, Strasberg SM. Proposed classification of complications of surgery with examples of utility in cholecystectomy. Surgery. 1992;111:518–526. ; Bassi C, Dervenis C, Butturini G, et al. Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery. 2005;138:8–13. ; Wente MN, Bassi C, Dervenis C, et al. Delayed gastric emptying (DGE) after pancreatic surgery: a suggested definition by the International Study Group of Pancreatic Surgery (ISGPS). Surgery. 2007;142:761–768. ; Wente MN, Veit JA, Bassi C, et al. Postpancreatectomy hemorrhage (PPH): an International Study Group of Pancreatic Surgery (ISGPS) definition. Surgery. 2007;142:20–25. ; Lof S, Moekotte AL, Al-Sarireh B, et al. Multicentre observational cohort study of implementation and outcomes of laparoscopic distal pancreatectomy. Br J Surg. 2019;106:1657–1665. ; Soreide K, Olsen F, Nymo LS, et al. A nationwide cohort study of resection rates and short-term outcomes in open and laparoscopic distal pancreatectomy. HPB (Oxford). 2019;21:669–678. ; Klompmaker S, van Zoggel DM, Watkins AA, et al. Nationwide evaluation of patient selection for minimally invasive distal pancreatectomy using american college of surgeons’ national quality improvement program. Ann Surg. 2017;266:1055–1061. ; Sahakyan MA, Edwin B, Kazaryan AM, et al. Perioperative outcomes and survival in elderly patients undergoing laparoscopic distal pancreatectomy. J Hepatobiliary Pancreat Sci. 2017;24:42–48. ; Sahakyan MA, Tholfsen T, Kleive D, et al. Laparoscopic distal pancreatectomy in patients with poor physical status. HPB (Oxford). 2021;23:877–881. ; van der Heijde N, Balduzzi A, Alseidi A, et al. The role of older age and obesity in minimally invasive and open pancreatic surgery: a systematic review and meta-analysis. Pancreatology. 2020;20:1234–1242. ; Asbun HJ, Moekotte AL, Vissers FL, et al. The miami international evidence-based guidelines on minimally invasive pancreas resection. Ann Surg. 2020;271:1–14. ; van Hilst J, Korrel M, Lof S, et al. Minimally invasive versus open distal pancreatectomy for pancreatic ductal adenocarcinoma (DIPLOMA): study protocol for a randomized controlled trial. Trials. 2021;22:608. ; Versteijne E, van Dam JL, Suker M, et al. Neoadjuvant chemoradiotherapy versus upfront surgery for resectable and borderline resectable pancreatic cancer: long-term results of the dutch randomized PREOPANC trial. J Clin Oncol. 2022;40:1220–1230. ; Markar SR, Ni M, Gisbertz SS, et al. Implementation of minimally invasive esophagectomy from a randomized controlled trial setting to national practice. J Clin Oncol. 2020;38:2130–2139. ; Adams AM, Russell DM, Carpenter EL, et al. Minimally invasive versus open distal pancreatectomy: a matched analysis using ACS-NSQIP. Surg Endosc. 2022;37:617–623. ; Korrel M, Lof S, Alseidi AA, et al. Framework for training in minimally invasive pancreatic surgery: an international delphi consensus study. J Am Coll Surg. 2022;235:383–390. ; Korrel M, Vissers FL, van Hilst J, et al. Minimally invasive versus open distal pancreatectomy: an individual patient data meta-analysis of two randomized controlled trials. HPB (Oxford). 2021;23:323–330. ; Van Buren G II, Bloomston M, Schmidt CR, et al. A prospective randomized multicenter trial of distal pancreatectomy with and without routine intraperitoneal drainage. Ann Surg. 2017;266:421–431. ; Vissers FL, Balduzzi A, van Bodegraven EA, et al. Prophylactic abdominal drainage or no drainage after distal pancreatectomy (PANDORINA): a binational multicenter randomized controlled trial. Trials. 2022;23:809. ; van der Heijde N, Lof S, Busch OR, et al. Incidence and impact of postoperative pancreatic fistula after minimally invasive and open distal pancreatectomy. Surgery. 2022;171:1658–1664. ; Smits FJ, Henry AC, Besselink MG, et al. Algorithm-based care versus usual care for the early recognition and management of complications after pancreatic resection in the Netherlands: an open-label, nationwide, stepped-wedge cluster-randomised trial. Lancet. 2022;399:1867–1875. ; De Pastena M, van Bodegraven EA, Mungroop TH, et al. Distal pancreatectomy Fistula Risk Score (D-FRS): development and international validation. Ann Surg. 2023;277:e1099–e1105. Entry Date(s): Date Created: 20230504 Date Completed: 20240111 Latest Revision: 20240201 Update Code: 20240201

Klicken Sie ein Format an und speichern Sie dann die Daten oder geben Sie eine Empfänger-Adresse ein und lassen Sie sich per Email zusenden.

BibTeX Citavi, JabRef, u.a.
(Literaturverwaltung)

PDF kein Volltext!
(Merkzettel, Notizen)

RIS Endnote, Citavi u.a.
(Literaturverwaltung)

MODS
(XML zur Weiterverarbeitung)

oder

Wählen Sie das für Sie passende Zitationsformat und kopieren Sie es dann in die Zwischenablage, lassen es sich per Mail zusenden oder speichern es als PDF-Datei.

Gewünschter Zitations-Stil:

oder

Bitte prüfen Sie, ob die Zitation formal korrekt ist, bevor Sie sie in einer Arbeit verwenden. Benutzen Sie gegebenenfalls den "Exportieren"-Dialog, wenn Sie ein Literaturverwaltungsprogramm verwenden und die Zitat-Angaben selbst formatieren wollen.

Nationwide use and Outcome of Minimally Invasive Distal Pancreatectomy in IDEAL Stage IV following a Training Program and Randomized Trial.