Laparoscopic versus open distal pancreatectomy for nonfunctioning pancreatic neuroendocrine tumors: a large single-center study
Laparoscopic versus open distal pancreatectomy for nonfunctioning pancreatic neuroendocrine tumors: a large single-center study
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DOI：
10.1007/s00464-017-5702-y
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发表时间：
2018-01-01
影响因子：
3.1
通讯作者：
You, Yung Hun
中科院分区：
文献类型：
--
作者：
Han, Sang Hyup;Han, In Woong;You, Yung Hun
胰腺神经内分泌肿瘤（PNED）占所有胰腺肿瘤的1-2%。非功能性PNDs（NF-PNDs）占所有PNDs的60-90%。腹腔镜远端胰腺切除术（LDP）正在成为胰腺体尾良性病变的首选治疗方法。然而，LDP尚未被广泛接受为NF-PNTR的黄金标准。本研究的目的是评价NF-PNTR患者腹腔镜与开放式远端胰腺切除术（ODP）后的临床和肿瘤学结局。1995年4月至2016年9月，94例NF-PNTR患者在三星医疗中心接受了开放式或腹腔镜远端胰腺切除术。患者被分为两组：接受LDP的患者和接受ODP的患者。比较两组患者的临床和肿瘤学变量，LDP患者的住院时间明显短于ODP患者，平均差异为2天（p < 0.001）。ODP组和LDP组的总体并发症发生率无显著差异（p = 0.379）。ODP组和LDP组的3年总生存率分别为93.7%和100%（p = 0.069）。在这项研究中，LDP治疗NF-PNP的肿瘤学结局与ODP相似。此外，与ODP相比，LDP与较短的住院时间相关。因此，LDP是一种安全有效的治疗NF-PNS的方法。需要多中心研究和随机对照试验来更好地评估临床和肿瘤学结果。
Pancreatic neuroendocrine tumors (PNETs) account for 1-2% of all pancreatic neoplasms. Nonfunctioning PNETs (NF-PNETs) account for 60-90% of all PNETs. Laparoscopic distal pancreatectomy (LDP) is becoming the treatment of choice for benign lesions in the body and tail of the pancreas. However, LDP has not yet been widely accepted as the gold standard for NF-PNETs. The purpose of this study is to evaluate the clinical and oncologic outcomes after laparoscopic versus open distal pancreatectomy (ODP) for NF-PNETs.Between April 1995 and September 2016, 94 patients with NF-PNETs underwent open or laparoscopic distal pancreatectomy at Samsung Medical Center. Patients were divided into two groups: those who underwent LDP and those who underwent ODP. Both groups were compared in terms of clinical and oncologic variables.LDP patients had a significantly shorter hospital stay compared with ODP patients, amounting to a mean difference of 2 days (p < 0.001). Overall complication rates did not differ significantly between the ODP and LDP groups (p = 0.379). The 3-year overall survival rates in the ODP and LDP groups were 93.7 and 100%, respectively (p = 0.069).In this study, LDP for NF-PNETs had similar oncologic outcomes compared with ODP. In addition, LDP was associated with a shorter hospital stay compared with ODP. Therefore, LDP is a safe and effective procedure for patients with NF-PNETs. A multicenter study and a randomized controlled trial are needed to better assess the clinical and oncologic outcomes.