Park Sung Eun, Lee Tae Yoon, Yoon Young Chul, Seo Chang Ho, Na Gun Hyung, Woo Yun Kyoung, You Dong Do, Hong Tae Ho
Department of Hepato-Biliary and Pancreas Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Sci Rep. 2025 Aug 6;15(1):28799. doi: 10.1038/s41598-025-10997-w.
This study compared the lateral approach laparoscopic spleen-preserving distal pancreatectomy (LA LSPDP) with the conventional approach to LSPDP (CA LSPDP) for benign to borderline malignant tumors in the pancreatic tail. A multicenter retrospective cohort of patients undergoing LA LSPDP or CA LSPDP for pancreatic tail tumors with a tumor center located beyond the left lateral border of the aorta was analyzed. A 1:1 propensity score matching (PSM) yielded 56 patients per group. A total of 172 patients were planned for LSPDP. After PSM, the tumor sizes were comparable (3.1 cm vs 3.3 cm, p = 0.549). However, resected specimens were longer in the CA LSPDP group (8.4 cm vs. 7.7 cm, p < 0.001). Rates of conversion to open surgery, the use of Warshaw's technique, and the need for combined splenectomy were not significantly different between the two groups. However, the LA LSPDP group had a shorter operation time (127.1 min vs. 161.1 min, p = 0.002) and less blood loss (106.2 cc vs. 291.4 cc, p = 0.001). The postoperative complication rates were similar (35.7% vs. 27.3%, p = 0.339). LA LSPDP is a safe and effective technique that reduces operative time and blood loss in pancreatic tail tumors; however, larger prospective studies are needed to confirm this finding.
本研究比较了外侧入路腹腔镜保留脾脏的胰体尾切除术（LA LSPDP）与传统入路LSPDP（CA LSPDP）治疗胰体尾良性至交界性恶性肿瘤的效果。分析了一个多中心回顾性队列，该队列中的患者因肿瘤中心位于主动脉左侧边界以外的胰体尾肿瘤接受LA LSPDP或CA LSPDP手术。1:1倾向评分匹配（PSM）后每组有56例患者。共有172例患者计划接受LSPDP手术。PSM后，肿瘤大小相当（3.1 cm对3.3 cm，p = 0.549）。然而，CA LSPDP组的切除标本更长（8.4 cm对7.7 cm，p < 0.001）。两组之间转为开放手术的比例、使用Warshaw技术的情况以及联合脾切除术的必要性没有显著差异。然而，LA LSPDP组的手术时间更短（127.1分钟对161.1分钟，p = 0.002），失血量更少（106.2 cc对291.4 cc，p = 0.001）。术后并发症发生率相似（35.7%对27.3%，p = 0.339）。LA LSPDP是一种安全有效的技术，可减少胰体尾肿瘤的手术时间和失血量；然而，需要更大规模的前瞻性研究来证实这一发现。
