HPB : the official journal of the International Hepato Pancreato Biliary Association · 2025
Efficacy and safety of TRIANGLE operation for pancreatic head and body cancer: a systematic review and meta-analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод пока не подготовлен
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Cao Rui, Xuan Yuerong, Gong Xiaowen, Pang Chengshuai, Dong Chenyang, Liang Chaojie
Аннотация
BACKGROUND: Despite growing adoption of the Heidelberg TRIANGLE operation for pancreatic head/body tumors, comprehensive analysis of its safety and outcomes remains lacking.
METHODS: Systematic searches using predefined criteria (inception-May 2024) across PubMed, Cochrane, Web of Science, Embase, Medline, CNKI and Wan-Fang databases identified eligible studies. Primary outcomes were R0 resection rates and survival; secondary outcomes were complications and recurrence. Meta-analysis utilized Stata 18.0.
RESULTS: This meta-analysis included 8 studies (1,106 patients). Compared to standard resection, the TRIANGLE group had longer operative times and higher postoperative diarrhea rates (P < 0.001), but demonstrated reduced 1-year (P = 0.001) and 3-year recurrence (P = 0.036), lower perioperative mortality (P = 0.032), and more extensive lymph node dissection (P = 0.004). No differences were observed in R0 rates (P = 0.171), survival (1-year P = 0.730; 3-year P = 0.136), or primary complications. Overall survival (P = 0.075) and recurrence rates (P = 0.137) showed no statistical significance.
CONCLUSION: TRIANGLE operation reduces 1/3-year recurrence rates vs standard resection but increases postoperative diarrhea, while achieving similar R0/R1 rates and survival outcomes. Its clinical benefits require validation through large multicenter RCTs.
METHODS: Systematic searches using predefined criteria (inception-May 2024) across PubMed, Cochrane, Web of Science, Embase, Medline, CNKI and Wan-Fang databases identified eligible studies. Primary outcomes were R0 resection rates and survival; secondary outcomes were complications and recurrence. Meta-analysis utilized Stata 18.0.
RESULTS: This meta-analysis included 8 studies (1,106 patients). Compared to standard resection, the TRIANGLE group had longer operative times and higher postoperative diarrhea rates (P < 0.001), but demonstrated reduced 1-year (P = 0.001) and 3-year recurrence (P = 0.036), lower perioperative mortality (P = 0.032), and more extensive lymph node dissection (P = 0.004). No differences were observed in R0 rates (P = 0.171), survival (1-year P = 0.730; 3-year P = 0.136), or primary complications. Overall survival (P = 0.075) and recurrence rates (P = 0.137) showed no statistical significance.
CONCLUSION: TRIANGLE operation reduces 1/3-year recurrence rates vs standard resection but increases postoperative diarrhea, while achieving similar R0/R1 rates and survival outcomes. Its clinical benefits require validation through large multicenter RCTs.