Robotic-assisted versus open non-reconstructive pancreatic surgery in children with benign and low-grade malignant pancreatic tumors: a two-center preliminary study.
In a retrospective two-center cohort of 74 children undergoing distal pancreatectomy or enucleation for benign or low-grade malignant pancreatic tumors, robotic and open surgery had similar complication rates, operative times, and hospital stays, while lower unadjusted blood loss with robotics was not confirmed after multivariable adjustment.
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In a retrospective two-center cohort of 74 children undergoing distal pancreatectomy or enucleation for benign or low-grade malignant pancreatic tumors, robotic and open surgery had similar complication rates, operative times, and hospital stays, while lower unadjusted blood loss with robotics was not confirmed after multivariable adjustment.
Research significance
The evidence suggests that robotic non-reconstructive pancreatic surgery may provide perioperative outcomes comparable to open surgery in selected pediatric patients; whether it meaningfully reduces blood loss, toxicity, or recovery burden remains an inference requiring larger prospective or carefully controlled studies.
Source abstract
There is a lack of systematic comparisons of perioperative outcomes between robotic-assisted and open non-reconstructive pancreatic surgery for children's benign or low-grade malignant pancreatic neoplasms. This retrospective two-center study (2019.01-2026.04) analyzed pediatric non-reconstructive pancreatic surgery (distal pancreatectomy/enucleation) for benign/low-grade malignant tumors, comparing robotic and open approaches. Intention-to-treat analysis, subgroup sensitivity analyses, and multivariate logistic regression were performed. A total of 74 pediatric patients were enrolled, with 44 in the robotic group and 30 in the open group. The two groups had comparable overall complication rates (40.9% vs. 40.0%, P = 0.938). Multivariate logistic regression with adjustment for tumor size and procedure type revealed that surgical approach was not independently associated with complications (OR = 0.70, 95% CI: 0.24-2.03, P = 0.513), whereas procedure type was an independent risk factor (enucleation vs. DP: OR = 3.10, 95% CI: 1.12-8.57, P = 0.030). The robotic group had less intraoperative blood loss than the open group [20 (6, 50) ml vs. 50 (30, 163) ml, P = 0.0012], but multivariate adjustment failed to confirm surgical approach as an independent factor influencing blood loss (P = 0.231). Operative time and postoperative hospital stay were comparable between the two groups. Sensitivity analyses in the pancreatic tail subgroup (n = 56) and the DP subgroup (n = 47) yielded results in line with the main analysis. In summary, robotic surgery is safe and viable for pediatric non-reconstructive pancreatic surgery, with complications similar to those of open surgery.