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Long term oncological outcome of laparoscopic techniques in pancreatic cancer
The laparoscopic technique in distal pancreatic resection (LDP) has been widely accepted, and outcome data support the hypothesis that survival is improved, partly due to improved postoperative safety and recovery, thus optimizing treatment with adjuvant chemotherapy. But laparoscopic pancreaticoduo...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Baishideng Publishing Group Inc
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6323502/ https://www.ncbi.nlm.nih.gov/pubmed/30631402 http://dx.doi.org/10.4253/wjge.v10.i12.383 |
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author | Buanes, Trond Edwin, Bjørn |
author_facet | Buanes, Trond Edwin, Bjørn |
author_sort | Buanes, Trond |
collection | PubMed |
description | The laparoscopic technique in distal pancreatic resection (LDP) has been widely accepted, and outcome data support the hypothesis that survival is improved, partly due to improved postoperative safety and recovery, thus optimizing treatment with adjuvant chemotherapy. But laparoscopic pancreaticoduodenectomy (LPD or Whipple-procedures) has spread more slowly, due to the complexity of the procedure. Surgical safety has been a problem in hospitals with low patient volume, resulting in raised postoperative mortality, requiring careful monitoring of outcome during the surgical learning curve. Robotic assistance is expected to improve surgical safety, but data on long term oncological outcome of laparoscopic Whipple procedures with or without robotic assistance is scarce. Future research should still focus surgical safety, but most importantly long term outcome, recorded as recurrence at maximal follow up or - at best - overall long term survival (OS). Available data show median survival above 2.5 years, five year OS more than 30% after LDP even in series with suboptimal adjuvant chemotherapy. Also after LPD, long term survival is reported equal to or longer than open resection. However, surgical safety during the learning curve of LPD is a problem, which hopefully can be facilitated by robotic assistance. Patient reported outcome should also be an endpoint in future trials, including patients with pancreatic ductal adenocarcinoma. |
format | Online Article Text |
id | pubmed-6323502 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-63235022019-01-10 Long term oncological outcome of laparoscopic techniques in pancreatic cancer Buanes, Trond Edwin, Bjørn World J Gastrointest Endosc Minireviews The laparoscopic technique in distal pancreatic resection (LDP) has been widely accepted, and outcome data support the hypothesis that survival is improved, partly due to improved postoperative safety and recovery, thus optimizing treatment with adjuvant chemotherapy. But laparoscopic pancreaticoduodenectomy (LPD or Whipple-procedures) has spread more slowly, due to the complexity of the procedure. Surgical safety has been a problem in hospitals with low patient volume, resulting in raised postoperative mortality, requiring careful monitoring of outcome during the surgical learning curve. Robotic assistance is expected to improve surgical safety, but data on long term oncological outcome of laparoscopic Whipple procedures with or without robotic assistance is scarce. Future research should still focus surgical safety, but most importantly long term outcome, recorded as recurrence at maximal follow up or - at best - overall long term survival (OS). Available data show median survival above 2.5 years, five year OS more than 30% after LDP even in series with suboptimal adjuvant chemotherapy. Also after LPD, long term survival is reported equal to or longer than open resection. However, surgical safety during the learning curve of LPD is a problem, which hopefully can be facilitated by robotic assistance. Patient reported outcome should also be an endpoint in future trials, including patients with pancreatic ductal adenocarcinoma. Baishideng Publishing Group Inc 2018-12-16 2018-12-16 /pmc/articles/PMC6323502/ /pubmed/30631402 http://dx.doi.org/10.4253/wjge.v10.i12.383 Text en ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. |
spellingShingle | Minireviews Buanes, Trond Edwin, Bjørn Long term oncological outcome of laparoscopic techniques in pancreatic cancer |
title | Long term oncological outcome of laparoscopic techniques in pancreatic cancer |
title_full | Long term oncological outcome of laparoscopic techniques in pancreatic cancer |
title_fullStr | Long term oncological outcome of laparoscopic techniques in pancreatic cancer |
title_full_unstemmed | Long term oncological outcome of laparoscopic techniques in pancreatic cancer |
title_short | Long term oncological outcome of laparoscopic techniques in pancreatic cancer |
title_sort | long term oncological outcome of laparoscopic techniques in pancreatic cancer |
topic | Minireviews |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6323502/ https://www.ncbi.nlm.nih.gov/pubmed/30631402 http://dx.doi.org/10.4253/wjge.v10.i12.383 |
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