Minimally invasive versus open distal pancreatectomy for resectable pancreatic neuroendocrine tumors: A propensity score matched multicentric comparative French study - Université de Picardie Jules Verne Accéder directement au contenu
Article Dans Une Revue Surgery Année : 2024

Minimally invasive versus open distal pancreatectomy for resectable pancreatic neuroendocrine tumors: A propensity score matched multicentric comparative French study

Giulia Canali
Alain Sauvanet
Julie Perinel
Mustapha Adham
  • Fonction : Auteur
Stylianos Tzedakis
  • Fonction : Auteur
David Birnbaum
  • Fonction : Auteur
Olivier Facy
Johan Gagniere
  • Fonction : Auteur
Sébastien Gaujoux
  • Fonction : Auteur
Ecoline Tribillon
Edouard Roussel
Lilian Schwarz
  • Fonction : Auteur
Louise Barbier
  • Fonction : Auteur
Nicolas Regenet
  • Fonction : Auteur
Antonio Iannelli
  • Fonction : Auteur
Guillaume Piessen
Stéphanie Truant
Mehdi El Amrani
  • Fonction : Auteur

Résumé

Background: Minimally invasive surgery has gained momentum for left pancreatic resections. However, debate remains about whether it has any advantage over open surgery for distal pancreatectomy for pancreatic neuroendocrine tumors. Methods: This retrospective review examined pancreatectomies performed for resectable pancreatic neuroendocrine tumors at 21 centers in France between January 2014 and December 2018. Short and long-term outcomes were compared before and after propensity score matching based on tumor size, sex, age, body mass index, center, and method of pancreatic transection. Results: During the period study, 274 patients underwent left pancreatic resection for pancreatic neuroendocrine tumors [109 underwent distal splenopancreatectomy, and 165 underwent spleen-preserving distal pancreatectomy [(splenic vessel preservation (n = 97; 58.7%)/splenic vessel resection (n = 68; 41.3%)]. Before propensity score matching, minimally invasive surgery was associated with a lower rate of major morbidity (P = .004), lower rate of postoperative delayed gastric emptying (P = .04), and higher rate of "textbook" outcomes (P = .04). After propensity score matching, there were 2 groups of 54 patients (n = 30 distal splenopancreatectomy; n = 78 spleen-preserving distal pancreatectomy). Minimally invasive surgery was associated with less blood loss (P = .05), decreased rate of major morbidity (6% vs. 24%; P = .02), less delayed gastric emptying (P = .05) despite similar rates of postoperative fistula, hemorrhage, and reoperation (P > .05). The 5-year overall survival (79% vs. 75%; P = .74) and recurrence-free survival (10% vs 17%; P = .39) were similar. Conclusion: Minimally invasive surgery for left pancreatic resection can be safely proposed for patients with resectable left pancreatic neuroendocrine tumors. Minimally invasive surgery decreases the rate of major complications while providing comparable long-term oncologic outcomes.
Fichier non déposé

Dates et versions

hal-04595024 , version 1 (30-05-2024)

Identifiants

Citer

Pietro Addeo, Pierre de Mathelin, Alexandre Doussot, Thibault Durin, Giulia Canali, et al.. Minimally invasive versus open distal pancreatectomy for resectable pancreatic neuroendocrine tumors: A propensity score matched multicentric comparative French study. Surgery, 2024, ⟨10.1016/j.surg.2024.04.005⟩. ⟨hal-04595024⟩
4 Consultations
0 Téléchargements

Altmetric

Partager

Gmail Mastodon Facebook X LinkedIn More