Is laparoscopic management suitable for solid pseudo-papillary tumors of the pancreas?
Is laparoscopic management suitable for solid pseudo-papillary tumors of the pancreas?
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DOI：
10.1007/s00383-009-2388-9
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发表时间：
2009-07-01
影响因子：
1.8
通讯作者：
de Lagausie, Pascal
中科院分区：
文献类型：
--
作者：
Fais, P. O.;Carricaburu, E.;de Lagausie, Pascal
实性假乳头状瘤是一种少见的低度恶性胰脏肿瘤，主要发生于年轻女性。本报告的目的是描述我们的经验与腹腔镜管理这些tumors.Three儿童与SPT的4年follows.Three被收进两家医院在巴黎，法国，2000年2月至2006年12月。采用腹腔镜技术进行诊断或治疗（1例活检和切除，2例仅活检）。收集了长期随访数据。所有3例患者均在切除后3年内出现复发，即，2例播散性腹膜复发，1例局部复发。2例腹膜复发患者均行手术切除和化疗。局部复发的患者由于禁忌的局部因素而无法治疗。这三个病人在写这篇文章的时候都还活着，这是第一篇描述腹腔镜治疗SPT后长期随访的报道。所有3例患者均出现复发。这些糟糕的结果与开腹手术后局部或播散性复发的低风险形成鲜明对比，而开腹手术后不化疗一直被认为是迄今为止的首选治疗。腹腔镜治疗后复发可能是由于气体吹入引起的肿瘤细胞扩散，特别是在活检过程中。对于出现SPT的患者，不应进行腹腔镜活检。
Solid pseudo-papillary tumors (SPT) are rare pancreatic neoplasms of low-malignant potential occurring mainly in young women. The purpose of this report is to describe our experience with laparoscopic management of these tumors with 4-year follow-up.Three children with SPT were admitted to two hospitals in Paris, France, between February 2000 and December 2006. Diagnosis or treatment was carried out using laparoscopic techniques (biopsy and resection in one case and biopsy only in two). Long-term follow-up data were collected.All three patients presented recurrences within 3 years after resection, i.e., disseminated peritoneal recurrence in two patients and local recurrence in one. The two patients with peritoneal recurrences were treated by surgical resection and chemotherapy. The patient with local recurrence could not be treated due to contraindicating local factors. All three patients were alive at the time of this writing.This is the first report describing long-term follow-up after laparoscopic management of SPT. All three patients developed recurrences. These poor results contrast sharply with the low risk of local or disseminated recurrence after open laparotomy without chemotherapy that has been considered as the treatment of choice up to now. Recurrences after laparoscopic management may have been due to diffusion of tumor cells caused by gas insufflation especially during biopsy. Laparoscopic biopsy should not be performed in patients presenting SPT.