Minimally invasive vs open pancreatectomy for nonfunctioning pancreatic neuroendocrine tumors

Abstract

BACKGROUND The mainstay of treating nonfunctioning-pancreatic neuroendocrine tumors(NF-PNETs) is surgical resection. However, minimally invasive approaches to pancreatic resection for treating NF-PNETs are not widely accepted, and the long-term oncological outcomes of such approaches remain unknown. AIM To determine the short- and long-term outcomes of minimally invasive pancreatic resection conducted in patients with NF-PNETs. METHODS Prospective databases from Severance Hospital were searched for 110 patients who underwent curative resection for NF-PNETs between January 2003 and August 2018. RESULTS The proportion of minimally invasive surgery (MIS) procedures performed for NF-PNET increased to more than 75% after 2013. There was no significant difference in post-operative complications ( P = 0.654), including pancreatic fistula ( P = 0.890) and delayed gastric emptying ( P = 0.652), between MIS and open approaches. No statistically significant difference was found in disease-free survival between the open approach group and the MIS group (median follow-up period, 28.1 mo; P = 0.428). In addition, the surgical approach (MIS vs open) was not found to be an independent prognostic factor in treating NF-PNET patients [Exp(β) = 1.062; P = 0.929]. CONCLUSION Regardless of the type of surgery, a minimally invasive approach can be safe and feasible for select NF-PNET patients.

Contemporary Approaches to the Surgical Management of Pancreatic Neuroendocrine Tumors

“…Another study by Kim and colleagues focusing on NF-PNETs found that MIS approaches yielded comparable disease-free and overall survival to open approaches, with shorter hospital stays despite longer operative duration in the MIS group. Furthermore, lymph node yield was similar between the approaches [61]. Sutton and colleagues recently corroborated these findings in a multi-institutional registry involving 282 patients [62].…”

Comparative Outcomes of Minimally Invasive Versus Open Pancreatoduodenectomy in Distal Cholangiocarcinoma: A Systematic Review and Meta-Analysis

“…Another relevant study to contrast our findings would be the article by Kim et al [ 29 ] who compared minimally invasive and open pancreatectomy for nonfunctioning pancreatic neuroendocrine tumors (NF-PNET). In the case of patients with a proximal location lesion, there was no significant difference in the average rates of postoperative complications.…”