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机器人手术方法能否扩大1型多发性神经内分泌肿瘤复发性胰腺神经内分泌肿瘤再次手术的适应症?

May the robotic approach expand the indications for redo surgery in recurrent pNETs in Multiple Neuroendocrine Neoplasia type 1?

作者信息

Baz Carolina, Dreifuss Nicolas H, Cubisino Antonio, Schlottmann Francisco, Mangano Alberto, Aguiluz Gabriela, Vanetta Carolina, Masrur Mario A, Giulianotti Pier Cristoforo

机构信息

Division of General, Minimally Invasive and Robotic Surgery, Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA.

出版信息

J Surg Case Rep. 2022 Sep 20;2022(9):rjac433. doi: 10.1093/jscr/rjac433. eCollection 2022 Sep.

Abstract

Pancreatic neuroendocrine tumors (pNETs) represent the leading cause of disease-specific mortality in patients with Multiple Neuroendocrine Neoplasia type 1 (MEN1). Although surgery is the recommended treatment for non-functional pNETs >2 cm, the management of recurrent lesions between 1 and 2 cm is controversial. Robotic surgery was used on a 29-year-old female with MEN1 and previous distal splenopancreatectomy that presented with a 1 cm recurrent pNET. The advantages offered by this approach facilitating a precise resection of the tumor and minimizing the postoperative morbidity may favor the decision towards redo surgery for local recurrences <2 cm, expanding current indications.

摘要

胰腺神经内分泌肿瘤(pNETs)是1型多发性神经内分泌肿瘤(MEN1)患者疾病特异性死亡的主要原因。尽管手术是直径>2 cm的无功能性pNETs的推荐治疗方法,但对于直径在1至2 cm之间的复发病变的管理仍存在争议。一名29岁患有MEN1且先前接受过远端脾胰切除术的女性患者出现了直径1 cm的复发性pNET,遂采用了机器人手术。这种方法具有能够精确切除肿瘤并将术后发病率降至最低的优势,可能有利于决定对直径<2 cm的局部复发进行再次手术,从而扩大当前的适应症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea8d/9491866/db93b1ee368d/rjac433f1.jpg

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