Minimally-invasive versus open enucleation for pancreatic tumours: A propensity-score adjusted analysis

Abstract

Backgrounds/Aims This study aims to evaluate the perioperative outcomes of minimally-invasive enucleation (MIEn) of the pancreas versus open enucleation (OEn). Methods This is a retrospective review of 20 consecutive patients who underwent pancreatic enucleation at a single institution. Results Seven patients underwent MIEn, of which 3 were robotic and 4 were laparoscopic. After propensity-adjusted analysis, the only significant difference was a reduced rate of readmissions within 30 days in the MIEn group versus the OEn group [0 vs 4 (30.8%), p =0.0464]. There were no conversions to open in the MIEn group, and median operation time was similar in both groups. There was no difference in median EBL in both groups, and none of the patients in our series required blood transfusions. The overall morbidity rate was 45.0% and the major complication (Clavien-Dindo>2) rate was 15%; which was similar between both groups. Seven (35%) patients had a Grade B/C POPF, and there was no significant difference between the two groups for this. The MIEn group had a shorter median length of stay compared to OEn [5 days (range, 3–24) vs 8.5 days (range, 5–42)] this was not significant on propensity-adjusted analysis ( p =0.3195). There was no post-operative 90-day/in-hospital mortality in all 20 patients. Conclusions Our experience demonstrates that MIEn was associated with similar perioperative outcomes and fewer readmissions compared to OEn.

Indications and outcomes of enucleation versus formal pancreatectomy for pancreatic neuroendocrine tumors

“…In addition, the majority of available studies report data from single center experiences or describe patients with a pNET as part of a larger study population, and, thus, the safety and efficacy of EN have not been thoroughly examined. [14][15][16][17][18] As such, the objective of the current study was to evaluate current surgical indications and complications of EN among patients with a pNET using a large multiinstitutional database. In addition, this study examined longterm outcomes among patients undergoing a parenchymalsparing procedure (i.e.…”

Case‐matched analysis of robotic versus open surgical enucleation for pancreatic tumours: A comparative cost‐effectiveness study

“…The introduction of robot‐assisted techniques has improved the well‐known limitations of the traditional laparoscopic approach, especially in the pancreatic area 1,3 . In recent years, several studies comparing robotic and open pancreatic enucleation have been published with satisfactory results 5,7,18 . The study by Tousif Kabir et al.…”

“…Furthermore, tissue‐sparing resections decrease the risk of exocrine or endocrine pancreatic insufficiency postoperatively and may also reduce surgical morbidity and mortality due to reduced operative trauma 6 . Robotic surgery for benign tumours and NET (pancreatic neuroendocrine tumours) has rarely been described in the literature, and the safety and efficiency of this technique remain unclear 7 . In this study, we compare robotic pancreatic enucleation (RPE) versus open pancreatic enucleation (OPE) performed at Sanchinarro University Hospital, Madrid, with the aim to evaluate the impact of the clinical outcome using cost‐effectiveness analysis.…”

Robotic enucleation of a pancreatic uncinate neuroendocrine tumor – a unique parenchyma-saving strategy for uncinate tumors

“…In comparing open and minimally invasive (MIS) approaches to PNET surgery, the latter has been reported to be non-inferior, and significantly associated with shorter operative time, lower morbidity and POPF rates, and decreased duration of hospital stay. [12][13][14] To date there exist only two meta-analyses specific to the comparison be-…”