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微创外科在神经内分泌肿瘤中有作用吗?

Is there any role for minimally invasive surgery in NET?

机构信息

Department of Surgery, University of Lübeck and University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.

Department of Visceral and General Surgery, University Medical Center Freiburg, Freiburg, Germany.

出版信息

Rev Endocr Metab Disord. 2017 Dec;18(4):443-457. doi: 10.1007/s11154-017-9436-x.

Abstract

Neuroendocrine tumors (NET) represent the variability of almost benign lesions either secreting hormones occurring as a single lesion up to malignant lesions with metastatic potential. Treatment of NET is usually performed by surgical resection. Due to the rarity of NET, surgical treatment is mainly based on the experience and recommendations of experts and less on the basis of prospective randomized studies. In addition, the development and establishment of new surgical procedures is made more difficult by their rarity. The development of laparoscopic-assisted surgery has significantly improved the treatment of many diseases. Due to the well-known advantages of laparoscopic surgery, this method has also been increasingly used to treat NET. However, due to limited comparative data, the assumed superiority of laparoscopic surgery in the area NET remains often unclear or not yet proven. This review focuses on the present usage of laparoscopic techniques in the area of NET. Relating to the current literature, this review presents the evidence of various laparoscopic procedures for treatment of adrenal, pancreatic and intestine NET as well as extraadrenal pheochromocytoma and neuroendocrine liver metastases. Further, this review focuses on recent new developments of minimally invasive surgery in the area of NET. Here, robotic-assisted surgery and single-port surgery are promising approaches.

摘要

神经内分泌肿瘤(NET)代表了从单一病变分泌激素的几乎良性病变的变异性,直至具有转移潜能的恶性病变。NET 的治疗通常通过手术切除进行。由于 NET 的罕见性,手术治疗主要基于专家的经验和建议,而不是基于前瞻性随机研究。此外,由于其罕见性,新手术程序的开发和建立更加困难。腹腔镜辅助手术的发展显著改善了许多疾病的治疗效果。由于腹腔镜手术的众所周知的优势,这种方法也越来越多地用于治疗 NET。然而,由于比较数据有限,腹腔镜手术在 NET 领域的假定优势仍然不明确或尚未得到证实。这篇综述重点介绍了腹腔镜技术在 NET 领域的目前应用。根据当前的文献,本综述介绍了各种腹腔镜手术治疗肾上腺、胰腺和肠道 NET 以及肾上腺外嗜铬细胞瘤和神经内分泌肝转移的证据。此外,本综述还重点介绍了 NET 领域微创外科的最新新进展。在这里,机器人辅助手术和单孔手术是很有前途的方法。

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