Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Oct 15, 2020; 12(10): 1133-1145
Published online Oct 15, 2020. doi: 10.4251/wjgo.v12.i10.1133
Minimally invasive vs open pancreatectomy for nonfunctioning pancreatic neuroendocrine tumors
Juwan Kim, Ho Kyoung Hwang, Woo Jung Lee, Chang Moo Kang
Juwan Kim, Department of Surgery, Yonsei University College of Medicine, Severance Hospital, Seoul 03722, South Korea
Ho Kyoung Hwang, Woo Jung Lee, Chang Moo Kang, Department of Surgery, Yonsei University College of Medicine, Seoul 03722, South Korea
Author contributions: Kang CM designed the report; Kim J collected the patient’s clinical data, analyzed the data, and wrote the paper; Hwang HK and Lee WJ revised the paper for important intellectual content.
Institutional review board statement: This study was approved by the Ethics Committee of the Yonsei University Health System, Severance Hospital, Institutional Review Board (No. 4-2019-1136).
Informed consent statement: The Hospital’s Institutional Review Board waived the requirement for informed consent in accordance with the retrospective nature of the study.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Data sharing statement: Data requests should be directed to juwankim1717@yuhs.ac.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Chang Moo Kang, MD, PhD, Professor, Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, Korea, Seoul 03722, South Korea. cmkang@yuhs.ac
Received: June 21, 2020
Peer-review started: June 21, 2020
First decision: July 30, 2020
Revised: August 17, 2020
Accepted: September 14, 2020
Article in press: September 14, 2020
Published online: October 15, 2020
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.

Keywords: Nonfunctioning-pancreas neuroendocrine tumor, Pancreatic neuroendocrine tumor, Minimally invasive surgery, Oncologic outcome, Laparoscopic pancreaticoduodenectomy, Laparoscopic distal pancreatectomy

Core Tip: 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. In this Long-term retrospective study with large numbers of subjects, there was no significant difference the short-term outcomes and recurrence rate of open resection and minimally invasive resection of NF-PNET.