Evidence map›Paper›PMID 38438677›Full record

ArticleSurgical endoscopy2024

Postoperative outcomes and costs of laparoscopic versus robotic distal pancreatectomy: a propensity-matched analysis.

Hester C Timmerhuis, Christopher W Jensen, Rejoice F Ngongoni, Michael Baiocchi, Jonathan C DeLong, Rika Ohkuma, Monica M Dua, Jeffrey A Norton, George A Poultsides, Patrick J Worth and 1 more

Abstract read
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Hester C TimmerhuisDepartment of Surgery, Stanford University School of Medicine, Stanford, CA, USA.ORCID 0000-0001-5714-4951
Christopher W JensenDepartment of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
Rejoice F NgongoniDepartment of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
Michael BaiocchiStanford Prevention Research Center and Departments of Statistics and Health Research and Policy, Stanford University, Stanford, CA, USA.
Jonathan C DeLongDepartment of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
Rika OhkumaDepartment of Quality, Stanford University School of Medicine, Stanford, CA, USA.
Monica M DuaDepartment of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
Jeffrey A NortonDepartment of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
George A PoultsidesDepartment of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
Patrick J WorthDepartment of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
Brendan C VisserDepartment of Surgery, Stanford University School of Medicine, Stanford, CA, USA. bvisser@stanford.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMinimally invasive distal pancreatectomy (MIDP) has established advantages over the open approach. The costs associated with robotic DP (RDP) versus laparoscopic DP (LDP) make the robotic approach controversial. We sought to compare outcomes and cost of LDP and RDP using propensity matching analysis at our institution.

methodsPatients undergoing LDP or RDP between 2000 and 2021 were retrospectively identified. Patients were optimally matched using age, gender, American Society of Anesthesiologists status, body mass index, and tumor size. Between-group differences were analyzed using the Wilcoxon signed-rank test for continuous data, and the McNemar's test for categorical data. Outcomes included operative duration, conversion to open surgery, postoperative length of stay, pancreatic fistula rate, pseudocyst requiring intervention, and costs.

results298 patients underwent MIDP, 180 (60%) were laparoscopic and 118 (40%) were robotic. All RDPs were matched 1:1 to a laparoscopic case with absolute standardized mean differences for all matching covariates below 0.10, except for tumor type (0.16). RDP had longer operative times (268 vs 178 min, p < 0.01), shorter length of stay (2 vs 4 days, p < 0.01), fewer biochemical pancreatic leaks (11.9% vs 34.7%, p < 0.01), and fewer interventional radiological drainage (0% vs 5.9%, p = 0.01). The number of pancreatic fistulas (11.9% vs 5.1%, p = 0.12), collections requiring antibiotics or intervention (11.9% vs 5.1%, p = 0.12), and conversion rates (3.4% vs 5.1%, p = 0.72) were comparable between the two groups. The total direct index admission costs for RDP were 1.01 times higher than for LDP for FY16-19 (p = 0.372), and 1.33 times higher for FY20-22 (p = 0.031).

conclusionsAlthough RDP required longer operative times than LDP, postoperative stays were shorter. The procedure cost of RDP was modestly more expensive than LDP, though this was partially offset by reduced hospital stay and reintervention rate.

Indexed as

LaparoscopyPancreatic NeoplasmsRobotic Surgical ProceduresHumansLength of StayOperative TimePancreatectomyPancreatic FistulaRetrospective StudiesTreatment OutcomeCost analysisLaparoscopic distal pancreatectomyMinimally invasive distal pancreatectomyRobotic distal pancreatectomy

Identifiers

PMID38438677

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.