Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Center for Endocrine and Neuroendocrine Tumours, Amsterdam UMC, Amsterdam, the Netherlands.
Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Center for Endocrine and Neuroendocrine Tumours, Amsterdam UMC, Amsterdam, the Netherlands.
Eur J Surg Oncol. 2022 Jun;48(6):1251-1257. doi: 10.1016/j.ejso.2021.11.011. Epub 2021 Nov 18.
Although minimally invasive surgery is becoming the standard technique in gastrointestinal surgery, implementation for small bowel neuroendocrine neoplasms (SB-NEN) is lagging behind. The aim of this international survey was to gain insights into attitudes towards minimally invasive surgery for resection of SB-NEN and current practices.
An anonymous survey was sent to surgeons between February and May 2021 via (neuro)endocrine and colorectal societies worldwide. The survey consisted of questions regarding experience of the surgeon with minimally invasive SB-NEN resection and training.
A total of 58 responses from five societies across 20 countries were included. Forty-one (71%) respondents worked at academic centers. Thirty-seven (64%) practiced colorectal surgery, 24 (41%) endocrine surgery and 45 (78%) had experience in advanced minimally invasive surgery. An open, laparoscopic or robotic approach was preferred by 23 (42%), 24 (44%), and 8 (15%) respondents, respectively. Reasons to opt for a minimally invasive approach were mainly related to peri-operative benefits, while an open approach was preferred for optimal mesenteric lymphadenectomy and tactile feedback. Additional training in minimally invasive SB-NEN resection was welcomed by 29 (52%) respondents. Forty-three (74%) respondents were interested in collaborating in future studies, with a cumulative median (IQR) annual case load of 172 (86-258).
Among respondents, 69% applies minimally invasive surgery for resection of SB-NEN. Arguments for specific operative approaches differ, and insufficient training in advanced laparoscopic techniques seems to be a barrier. Future collaborative studies can provide better insight in selection criteria and optimal technique.
虽然微创手术已成为胃肠外科的标准技术，但在小肠神经内分泌肿瘤（SB-NEN）的应用中却落后了。本次国际调查旨在深入了解外科医生对微创 SB-NEN 切除术的态度和当前的实践。
2021 年 2 月至 5 月，通过全球（神经）内分泌和结直肠学会向外科医生发送了匿名调查。调查内容包括外科医生微创 SB-NEN 切除和培训的经验。
共收到来自五个国家/地区的五个学会的 58 份回复，来自 20 个国家。41 名（71%）受访者在学术中心工作。37 名（64%）从事结直肠外科，24 名（41%）从事内分泌外科，45 名（78%）有微创高级手术经验。分别有 23 名（42%）、24 名（44%）和 8 名（15%）受访者首选开放式、腹腔镜或机器人方法。选择微创方法的主要原因是围手术期获益，而开放式方法则更适合肠系膜淋巴结清扫术和触觉反馈。29 名（52%）受访者欢迎接受微创 SB-NEN 切除术的额外培训。43 名（74%）受访者有兴趣在未来的研究中合作，累积中位数（IQR）年手术量为 172（86-258）例。
在受访者中，69%的人应用微创手术切除 SB-NEN。具体手术方法的选择理由不同，缺乏高级腹腔镜技术的培训似乎是一个障碍。未来的合作研究可以更好地了解选择标准和最佳技术。
