Jarry Julien, Bodin Rodolphe, Peycru Thierry, Nunez Manuel, Collet Denis, Cunha Antonio Sa
Department of Digestive Surgery, Robert Picqué Hospital, Villenave d'Ornon, France.
JSLS. 2012 Oct-Dec;16(4):552-8. doi: 10.4293/108680812X13462882736970.
Since the first case report regarding laparoscopic distal pancreatectomy (DP) for solid pseudopapillary tumor (SPT), few additional articles have been published. The objective of this study was to evaluate the feasibility, safety, and long-term outcome of the laparoscopic DP based on a series of adult SPT patients.
In a single-center study, we screened all adult patients undergoing a laparoscopic DP for SPT. Preoperative, operative, and postoperative data were retrospectively analysed and compared to the results of open DP for SPT published in the medical literature.
From April 2000 to June 2010, 5 adult female patients (median age 34 y) underwent a laparoscopic DP for an SPT. No conversion to open surgery was required. The median size of the tumor was 45 mm. The postoperative mortality rate was 0%, and serious complications (Dindo IV) occurred in 2 patients. The postoperative quality of life was not significantly altered by the laparoscopic procedure. At a median follow-up of 60 mo, all patients were alive and without evidence of local recurrence, distant metastasis, diabetes, or exocrine insufficiency.
Laparoscopy may offer an alternative to open surgery in the treatment of SPT of the distal pancreas in adult female patients. The laparoscopic procedure impacts neither the oncologic outcome nor the quality of life. However, due to the risk of postoperative complications, this procedure should be reserved for specialized centers.
自首例关于腹腔镜下远端胰腺切除术(DP)治疗实性假乳头状瘤(SPT)的病例报告以来,鲜有其他相关文章发表。本研究的目的是基于一系列成年SPT患者评估腹腔镜DP的可行性、安全性和长期疗效。
在一项单中心研究中,我们筛选了所有接受腹腔镜DP治疗SPT的成年患者。对术前、术中及术后数据进行回顾性分析,并与医学文献中发表的开放性SPT-DP结果进行比较。
2000年4月至2010年6月,5例成年女性患者(中位年龄34岁)接受了腹腔镜DP治疗SPT。无需转为开放手术。肿瘤的中位大小为45mm。术后死亡率为0%,2例患者发生严重并发症(Dindo IV级)。腹腔镜手术未显著改变术后生活质量。中位随访60个月时,所有患者均存活,无局部复发、远处转移、糖尿病或外分泌功能不全的证据。
对于成年女性患者远端胰腺SPT的治疗,腹腔镜手术可能是开放手术的一种替代方法。腹腔镜手术既不影响肿瘤学结局,也不影响生活质量。然而,由于存在术后并发症的风险,该手术应仅在专业中心开展。