Kim Juwan, Hwang Ho Kyoung, Lee Woo Jung, Kang Chang Moo
Department of Surgery, Yonsei University College of Medicine, Severance Hospital, Seoul 03722, South Korea.
Department of Surgery, Yonsei University College of Medicine, Seoul 03722, South Korea.
World J Gastrointest Oncol. 2020 Oct 15;12(10):1133-1145. doi: 10.4251/wjgo.v12.i10.1133.
The mainstay of treating nonfunctioning-pancreatic neuroendocrine tumors(NF-PNETs) is surgical resection. However, minimally invasive approaches to pancreatic resection for treating NF-PNETs are not widely accepted, and the long-term oncological outcomes of such approaches remain unknown.
To determine the short- and long-term outcomes of minimally invasive pancreatic resection conducted in patients with NF-PNETs.
Prospective databases from Severance Hospital were searched for 110 patients who underwent curative resection for NF-PNETs between January 2003 and August 2018.
The proportion of minimally invasive surgery (MIS) procedures performed for NF-PNET increased to more than 75% after 2013. There was no significant difference in post-operative complications ( = 0.654), including pancreatic fistula ( = 0.890) and delayed gastric emptying ( = 0.652), between MIS and open approaches. No statistically significant difference was found in disease-free survival between the open approach group and the MIS group (median follow-up period, 28.1 mo; = 0.428). In addition, the surgical approach (MIS open) was not found to be an independent prognostic factor in treating NF-PNET patients [Exp(β) = 1.062; = 0.929].
Regardless of the type of surgery, a minimally invasive approach can be safe and feasible for select NF-PNET patients.
手术切除是无功能性胰腺神经内分泌肿瘤（NF-PNETs）的主要治疗方法。然而，用于治疗NF-PNETs的胰腺切除微创手术方法尚未被广泛接受，且此类方法的长期肿瘤学结局仍不明确。
确定NF-PNETs患者接受微创胰腺切除的短期和长期结局。
检索Severance医院的前瞻性数据库，纳入2003年1月至2018年8月期间接受NF-PNETs根治性切除的110例患者。
2013年后，NF-PNETs的微创手术（MIS）比例增至75%以上。MIS与开放手术在术后并发症（P = 0.654）方面无显著差异，包括胰瘘（P = 0.890）和胃排空延迟（P = 0.652）。开放手术组与MIS组的无病生存率无统计学显著差异（中位随访期28.1个月；P = 0.428）。此外，手术方式（MIS或开放）并非治疗NF-PNETs患者的独立预后因素[Exp(β)=1.062；P = 0.929]。
对于部分NF-PNETs患者，无论手术类型如何，微创方法都是安全可行的。
