Department of Surgery and Department of Biomedical and Clinical Sciences, Linköping University, 58185, Linköping, Sweden.
Department of Surgery and Department of Biomedical and Clinical Sciences, Linköping University, 58185, Linköping, Sweden.
Eur J Surg Oncol. 2024 Feb;50(2):107936. doi: 10.1016/j.ejso.2023.107936. Epub 2023 Dec 28.
Neuroendocrine neoplasms (SI-NEN) are the commonest malignancies of the small intestine. Traditionally, surgical treatment for SI-NEN has been open surgery.
The purpose of this study was to compare minimally invasive surgery (MIS) with the traditional open surgery approach for treating SI-NEN in a Swedish population.
Patients with histopathological confirmed SI-NEN who underwent open surgery or MIS resection within 2009-2021 were extracted from the hospital's medical records.
65 patients were included in this study, with 35 (54 %) undergoing MIS and 30 (46 %) undergoing open surgery. We found no statistically significant difference (p = 0.173) in the frequency of R0 resections (MIS group n = 34 (97 %), open surgery group n = 26 (87 %)). Nor was there a significant difference (p = 0.101) when comparing the median number of resected lymph nodes (MIS group n = 13.5, open surgery group n = 10). A post-operative paralytic ileus was more often reported (p = 0.052) in the MIS group (n = 9, 26 %) compared to the open surgery group (n = 2, 7 %). In light of this, the days of hospital stay did not differ significantly (MIS group median = 6, IQR (5-8), open surgery group median = 6, IQR (5-9)). The Kaplan-Meier analysis did not reveal differences concerning cancer-related deaths (p = 0.109).
The results from this study support that a MIS approach for the treatment of SI-NEN may not be inferior to open surgery. The higher number of resected lymph nodes and R0 resections may even speak in favor for a MIS approach. More studies with a longer time of observation are needed to further support this conclusion.
神经内分泌肿瘤（SI-NEN）是小肠最常见的恶性肿瘤。传统上，SI-NEN 的治疗方法是开放性手术。
本研究旨在比较微创外科（MIS）与传统开放性手术治疗瑞典人群中 SI-NEN 的效果。
从医院病历中提取 2009 年至 2021 年内接受开放性手术或 MIS 切除术的组织学证实的 SI-NEN 患者。
本研究纳入 65 例患者，其中 35 例（54%）接受 MIS 治疗，30 例（46%）接受开放性手术。我们发现 RO 切除的频率无统计学差异（p=0.173）（MIS 组 n=34（97%），开放性手术组 n=26（87%））。两组切除的淋巴结中位数也无显著差异（p=0.101）（MIS 组 n=13.5，开放性手术组 n=10）。MIS 组术后麻痹性肠梗阻的发生率更高（p=0.052）（n=9，26%），而开放性手术组为（n=2，7%）。尽管如此，住院天数并无显著差异（MIS 组中位数=6，IQR（5-8），开放性手术组中位数=6，IQR（5-9））。Kaplan-Meier 分析显示，两组癌症相关死亡率无差异（p=0.109）。
本研究结果支持 MIS 治疗 SI-NEN 可能并不逊于开放性手术。切除的淋巴结数量更多和 RO 切除率更高可能更支持 MIS 方法。需要更多具有更长观察时间的研究来进一步支持这一结论。
