Although adaptation of MIS for this difficult-to-reach gland is recent, the growing trend points to improved patient outcomes, such as reduced bleeding and infections. Now published online, the paper will appear in the March print edition of JAMA Surgery.
"For the first time, we show a nationwide tripling of keyhole pancreatic surgery rates for benign and malignant pancreatic disease from 2.4 percent in 1998 to 7.3 percent in 2009. Both laparoscopic and robotic approaches for distal pancreas removal are associated with lower rates of inpatient complications and shorter hospital stays," said Jason Sicklick, MD, assistant professor of surgery, UC San Diego School of Medicine, and surgical oncologist at UC San Diego Health System. "Patients should know that select approaches for minimally invasive pancreatic operations are safe depending upon the lesion's size and location in the pancreas."
The pancreas is a large gland located deep in the abdomen, behind the stomach and next to the spleen. The gland produces digestive juices and hormones that regulate blood sugar. To a surgeon's hand, the pancreas has a soft consistency. Due to its fragility and location near major vascular structures, the pancreas has been one of the last organs to be part of the MIS trend.
Sicklick added that with increased surgeon experience performing complex pancreatic and hepatobiliary operations, the application of minimally invasive techniques has slowly diffused from academic hospitals to the community setting. However, it has yet to reach its maximum potential.
The retrospective study compared utilization trends between MIS and traditional open techniques for pancreatic cancer operations from 1998 to 2009. Researchers evaluated in-hospital mortality, complication rates, total charges and length of stay. MIS was associated with lower rates of pre-discharge complications, including lower incidences of post-operative infections and bleeding complications, as well as a shorter length of stay, by 1.22 days.
Compared to patients undergoing an open procedure, patients who underwent a MIS procedure were older and more likely to have undergone surgery at a teaching hospital. Surgery performed at a teaching institution was associated with better outcomes for nearly every analyzed parameter.
"This study demonstrates the need for ongoing population-level monitoring of novel surgical procedures, to make sure that they retain their safety and effectiveness profiles as they diffuse from top academic hospitals to the rest of the population," said co-author David C. Chang, PhD, MPH, director of Outcomes Research in the Department of Surgery at UCSD School of Medicine. "This is something that UC San Diego Health System is committed to doing on an ongoing basis."
Sicklick added that the minimally invasive surgery approach does not translate into lower total charges, possibly due to the increased expenses of longer operative times and costly surgical instruments used in these types of operations.
Additional contributors to the paper included Hop S. Tran Cao, MD, Nicole Lopez, MD, Andrew M. Lowy, MD, Michael Bouvet, MD, Joel M. Baumgartner, MD, and Mark A. Talamini, MD, all at UCSD.
Jackie Carr | EurekAlert!
'Neuron-reading' nanowires could accelerate development of drugs for neurological diseases
12.04.2017 | University of California - San Diego
PET radiotracer design for monitoring targeted immunotherapy
10.04.2017 | Society of Nuclear Medicine
More and more automobile companies are focusing on body parts made of carbon fiber reinforced plastics (CFRP). However, manufacturing and repair costs must be further reduced in order to make CFRP more economical in use. Together with the Volkswagen AG and five other partners in the project HolQueSt 3D, the Laser Zentrum Hannover e.V. (LZH) has developed laser processes for the automatic trimming, drilling and repair of three-dimensional components.
Automated manufacturing processes are the basis for ultimately establishing the series production of CFRP components. In the project HolQueSt 3D, the LZH has...
Reflecting the structure of composites found in nature and the ancient world, researchers at the University of Illinois at Urbana-Champaign have synthesized thin carbon nanotube (CNT) textiles that exhibit both high electrical conductivity and a level of toughness that is about fifty times higher than copper films, currently used in electronics.
"The structural robustness of thin metal films has significant importance for the reliable operation of smart skin and flexible electronics including...
The nearby, giant radio galaxy M87 hosts a supermassive black hole (BH) and is well-known for its bright jet dominating the spectrum over ten orders of magnitude in frequency. Due to its proximity, jet prominence, and the large black hole mass, M87 is the best laboratory for investigating the formation, acceleration, and collimation of relativistic jets. A research team led by Silke Britzen from the Max Planck Institute for Radio Astronomy in Bonn, Germany, has found strong indication for turbulent processes connecting the accretion disk and the jet of that galaxy providing insights into the longstanding problem of the origin of astrophysical jets.
Supermassive black holes form some of the most enigmatic phenomena in astrophysics. Their enormous energy output is supposed to be generated by the...
The probability to find a certain number of photons inside a laser pulse usually corresponds to a classical distribution of independent events, the so-called...
Microprocessors based on atomically thin materials hold the promise of the evolution of traditional processors as well as new applications in the field of flexible electronics. Now, a TU Wien research team led by Thomas Müller has made a breakthrough in this field as part of an ongoing research project.
Two-dimensional materials, or 2D materials for short, are extremely versatile, although – or often more precisely because – they are made up of just one or a...
20.04.2017 | Event News
18.04.2017 | Event News
03.04.2017 | Event News
24.04.2017 | Physics and Astronomy
24.04.2017 | Materials Sciences
24.04.2017 | Life Sciences