{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T11:27:11Z","timestamp":1786706831945,"version":"build-2736575974"},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:00:00Z","timestamp":1769731200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:00:00Z","timestamp":1769731200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82303263"],"award-info":[{"award-number":["82303263"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We aimed to, for the first time, assess the value of modified textbook outcome (mTO) in robot\u2010assisted middle pancreatectomy (RMP) procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Summary Background Data<\/jats:title>\n                    <jats:p>Pancreatic fistula remains to be the major complication after RMP. Textbook outcome (TO) is introduced to capture the most desirable surgical outcomes. The value of TO in RMP surgery remains unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All patients who underwent RMP in our center from 2010 to 2023 were enrolled in the study. Baseline characteristics, operative outcomes, and oncological outcomes were collected and analyzed. Textbook outcome was calculated separately for each patient and analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mTO was defined by the absence of modified post\u2010operative pancreatic fistula (mPOPF), postpancreatectomy hemorrhage (PPH), severe complications (Clavien\u2013Dindo\u2009\u2265\u2009III), readmission, and in\u2010hospital mortality (IHM). The overall mTO rate and mPOPF rate of 209 patients were 73.68% and 15.79%, respectively. Patients who achieved modified textbook outcomes have shorter post\u2010operative hospitalization days (median (IQR), 17 (9) vs. 34 (26),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Passing the learning curve leads to a reduction of the mPOPF rate and an increase of the mTO rate.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Modified textbook outcome is a practical metric for evaluating ideal surgical outcomes in RMP surgery. Follow\u2010up multi\u2010center clinical research is necessary to evaluate this indicator even further.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.71542","type":"journal-article","created":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T10:06:01Z","timestamp":1769767561000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development of a Modified Textbook Outcome in Evaluating Robot\u2010Assisted Middle Pancreatectomy: A Real\u2010World Study of\n                    <scp>RMP<\/scp>\n                    Surgery in a High\u2010Volume Pancreatic Disease Center"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2010-5729","authenticated-orcid":false,"given":"Jingfeng","family":"Li","sequence":"first","affiliation":[{"name":"Department of General Surgery, Pancreatic Disease Center, Ruijin Hospital Shanghai Jiao Tong University School of Medicine  Shanghai 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