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Published in: World Journal of Surgery 9/2020

01-09-2020 | Pancreatectomy | Original Scientific Report

Minimally Invasive Versus Open Pancreatectomies for Pancreatic Neuroendocrine Neoplasms: A Propensity-Score-Matched Study

Authors: Hwee-Leong Tan, Roxanne Y. A. Teo, Nicholas L. Syn, Jin-Yao Teo, Ser-Yee Lee, Peng-Chung Cheow, Pierce K. H. Chow, Alexander Y. F. Chung, London L. P. J. Ooi, Chung-Yip Chan, Brian K. P. Goh

Published in: World Journal of Surgery | Issue 9/2020

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Abstract

Background

Pancreatic neuroendocrine neoplasms (PNENs) are increasingly prevalent with modern imaging, and surgical excision remains mainstay of treatment. This study aims to perform a propensity-score-matched (PSM) comparison of perioperative and oncologic outcomes following minimally invasive pancreatectomy (MIP) versus open pancreatectomy (OP) for PNEN.

Methods

A retrospective review was performed on patients who underwent curative-intent surgery for PNEN at Singapore General Hospital from 1997 to 2018. A 1:1 PSM was performed between MIP and OP, after which both groups were balanced for baseline variables.

Results

We studied 134 patients who underwent surgery (36 MIP and 98 OP) for PNEN. Propensity-score-matched comparison between 35 MIP and 35 OP patients revealed that the MIP group had a longer operating time (MD = 75.0, 95% CI 15.2 to 134.8, P = 0.015), lower intraoperative blood loss (MD = − 400.0, 95% CI − 630.5 to − 169.5, P = 0.001), shorter median postoperative stay (MD = − 1.0, 95% CI − 1.9 to − 0.1, P = 0.029) and shorter median time to diet (MD = − 1.0, 95% CI − 1.9 to − 0.1, P = 0.039). There were no differences between both groups for short-term adverse outcomes and oncologic clearance. Overall survival (HR = 0.84, 95% CI 0.28 to 2.51, P = 0.761) and disease-free survival (HR = 0.57, 95% CI 0.20 to 1.64, P = 0.296) were comparable.

Conclusion

MIP is a safe and feasible approach for PNEN and is associated with a lower intraoperative blood loss, decreased postoperative stay and time to oral intake, at the expense of a longer operative time compared to OP.
Appendix
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Metadata
Title
Minimally Invasive Versus Open Pancreatectomies for Pancreatic Neuroendocrine Neoplasms: A Propensity-Score-Matched Study
Authors
Hwee-Leong Tan
Roxanne Y. A. Teo
Nicholas L. Syn
Jin-Yao Teo
Ser-Yee Lee
Peng-Chung Cheow
Pierce K. H. Chow
Alexander Y. F. Chung
London L. P. J. Ooi
Chung-Yip Chan
Brian K. P. Goh
Publication date
01-09-2020
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 9/2020
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-020-05582-3

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