MEN1患者的机器人辅助保留脾脏的胰腺手术

Robot-assisted spleen preserving pancreatic surgery in MEN1 patients.

作者信息

Nell Sjoerd, Brunaud Laurent, Ayav Ahmet, Bonsing Bert A, Groot Koerkamp Bas, Nieveen van Dijkum Els J, Kazemier Geert, de Kleine Ruben H J, Hagendoorn Jeroen, Molenaar I Quintus, Valk Gerlof D, Borel Rinkes Inne H M, Vriens Menno R

机构信息

Department of Endocrine Surgical Oncology and Endocrine Oncology, University Medical Center Utrecht, Utrecht, The Netherlands.

Department of Digestive, Hepatobiliary and Endocrine Surgery, Université de Lorraine, Hôpital Brabois Adultes, CHU Nancy, Nancy, France.

出版信息

J Surg Oncol. 2016 Sep;114(4):456-61. doi: 10.1002/jso.24315. Epub 2016 Jun 6.

DOI:10.1002/jso.24315

PMID:27263513

Abstract

BACKGROUND

Multiple Endocrine Neoplasia type 1 (MEN1) patients often undergo multiple pancreatic operations at a young age.

OBJECTIVE

To describe robot-assisted and laparoscopic spleen-preserving pancreatic surgery in MEN1 patients, and to compare both techniques.

METHODS

Robot-assisted pancreatectomies of the DutchMEN1 study group and the Université de Lorraine, Nancy, France were compared to a historical cohort of laparoscopic treated MEN1 patients. Perioperative outcomes were compared.

RESULTS

A total of 21 MEN1 patients underwent minimally invasive pancreatic surgery for pancreatic neuroendocrine tumors, seven patients were subjected to robot-assisted surgery, and 14 patients underwent laparoscopic surgery. Demographics and clinical characteristics did not differ between the cohorts and no significant differences in operative outcomes were found. A high number of ISGPS grade B/C pancreatic fistulas were observed in both cohorts (38%), and no conversions were seen in the robot-assisted cohort (respectively 0% vs. 43%, P = 0.06). In one laparoscopic and one robot-assisted case the primary tumor was not resected.

CONCLUSIONS

Minimally invasive spleen-preserving surgery in MEN1 patients is safe and feasible. Patients who underwent robot-assisted surgery did not require conversion to open surgery. J. Surg. Oncol. 2016;114:456-461. © 2016 Wiley Periodicals, Inc.

摘要

背景

1型多发性内分泌腺瘤病（MEN1）患者常在年轻时接受多次胰腺手术。

目的

描述MEN1患者的机器人辅助和腹腔镜保脾胰腺手术，并比较这两种技术。

方法

将荷兰MEN1研究组和法国南锡洛林大学的机器人辅助胰腺切除术与一组接受腹腔镜治疗的MEN1患者的历史队列进行比较。比较围手术期结果。

结果

共有21例MEN1患者因胰腺神经内分泌肿瘤接受了微创胰腺手术，7例患者接受了机器人辅助手术，14例患者接受了腹腔镜手术。各队列之间的人口统计学和临床特征无差异，手术结果也未发现显著差异。两个队列中均观察到大量ISGPS B/C级胰瘘（38%），机器人辅助队列中未出现中转开腹情况（分别为0%对43%，P = 0.06）。在1例腹腔镜手术和1例机器人辅助手术病例中，原发肿瘤未切除。