Robotic-assisted pancreatic surgery in the elderly patient: experiences from a high-volume centre
Karl H. Hillebrandt,
Sebastian Knitter,
Lea Timmermann,
Matthäus Felsenstein,
Christian Benzing,
Moritz Schmelzle,
Johann Pratschke,
Thomas Malinka
Affiliations
Karl H. Hillebrandt
Department of Surgery, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin Institute of Health, Campus Virchow Klinikum I Campus Charité Mitte
Sebastian Knitter
Department of Surgery, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin Institute of Health, Campus Virchow Klinikum I Campus Charité Mitte
Lea Timmermann
Department of Surgery, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin Institute of Health, Campus Virchow Klinikum I Campus Charité Mitte
Matthäus Felsenstein
Department of Surgery, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin Institute of Health, Campus Virchow Klinikum I Campus Charité Mitte
Christian Benzing
Department of Surgery, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin Institute of Health, Campus Virchow Klinikum I Campus Charité Mitte
Moritz Schmelzle
Department of Surgery, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin Institute of Health, Campus Virchow Klinikum I Campus Charité Mitte
Johann Pratschke
Department of Surgery, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin Institute of Health, Campus Virchow Klinikum I Campus Charité Mitte
Thomas Malinka
Department of Surgery, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin Institute of Health, Campus Virchow Klinikum I Campus Charité Mitte
Abstract Background Robotic-assisted pancreatic surgery (RPS) has fundamentally developed over the past few years. For subgroups, e.g. elderly patients, applicability and safety of RPS still needs to be defined. Given prognosticated demographic developments, we aim to assess the role of RPS based on preoperative, operative and postoperative parameters. Methods We included 129 patients undergoing RPS at our institution between 2017 and 2020. Eleven patients required conversion to open surgery and were excluded from further analysis. We divided patients into two groups; ≥ 70 years old (Group 1; n = 32) and < 70 years old (Group 2; n = 86) at time of resection. Results Most preoperative characteristics were similar in both groups. However, number of patients with previous abdominal surgery was significantly higher in patients ≥ 70 years old (78% vs 37%, p < 0.0001). Operative characteristics did not significantly differ between both groups. Although patients ≥ 70 years old stayed significantly longer at ICU (1.8 vs 0.9 days; p = 0.037), length of hospital stay and postoperative morbidity were equivalent between the groups. Conclusion RPS is safe and feasible in elderly patients and shows non-inferiority when compared with younger patients. However, prospectively collected data is needed to define the role of RPS in elderly patients accurately. Trial registration Clinical Trial Register: Deutschen Register Klinischer Studien (DRKS; German Clinical Trials Register). Clinical Registration Number: DRKS00017229 (retrospectively registered, Date of Registration: 2019/07/19, Date of First Enrollment: 2017/10/18).
