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- Title
Outcome and survival were similar with laparoscopic and open pancreatectomy in 102 solid pseudopapillary neoplasms.
- Authors
Codjia, Tatiana; Marique, Lancelot; Aussilhou, Béatrice; Ftériche, Fadhel Samir; de Mestier, Louis; Rebours, Vinciane; Cros, Jérome; Ruszniewski, Philippe; Lévy, Philippe; Lesurtel, Mickael; Sauvanet, Alain; Dokmak, Safi
- Abstract
Background: Solid pseudopapillary neoplasms of the pancreas (SPNP) are rare tumors predominantly in young women. We report the largest single-center cohort study comparing resection of SPNP by laparoscopic approach (LA) and the open approach (OA). Method: Between 2001 and 2021, 102 patients (84% women, median age: 30) underwent pancreatectomy for SPNP and were retrospectively studied. Demographic, perioperative, pathological, early and the long-term results were evaluated between patients operated by LA and those by OA. Results: Population included 40 LA and 62 OA. There were no significant differences in demographics data between the groups. A preoperative biopsy by endoscopic ultrasound was performed in 45 patients (44%) with no difference between the groups. Pancreatoduodenectomy (PD) was less frequently performed by LA (25 vs 53%, p = 0.004) and distal pancreatectomy (DP) was more frequently performed by LA (40 vs 16%, p = 0.003). In the subgroup analysis by surgical procedure, LA-PD was associated with one mortality, less median blood loss (180 vs 200 ml, p = 0.034) and fewer harvested lymph nodes (11 vs 15, p = 0.02). LA-DP was associated with smaller median tumor size on imaging (40 vs 80mm, p = 0.048), shorter surgery (135 vs 190 min, p = 0.028), and fewer complications according to the median comprehensive complication index score (0 vs 8.7, p = 0.048). LA-Central pancreatectomy was associated with shorter surgery (160 vs 240, p = 0.037), less median blood loss (60 vs 200, p = 0.043), and less harvested lymph nodes (5 vs 2, p = 0.025). After a median follow-up of 60 months, two recurrences (2%) were observed and were unrelated to the approach. Conclusions: The LA for SPNP appears to be safe, should be applied cautiously in case of PD for large lesion, and was not associated with recurrence.
- Subjects
FRANCE; SURVIVAL; LYMPH nodes; T-test (Statistics); CANCER relapse; LAPAROSCOPIC surgery; TREATMENT effectiveness; RETROSPECTIVE studies; DESCRIPTIVE statistics; CHI-squared test; SURGICAL blood loss; PANCREATIC tumors; PANCREATECTOMY; COMPARATIVE studies; DATA analysis software; EVALUATION
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2024, Vol 38, Issue 4, p2169
- ISSN
1866-6817
- Publication type
Article
- DOI
10.1007/s00464-024-10708-y