The Journal of surgical research · 2025
Spleen Preservation in Solid Pseudopapillary Neoplasms of the Distal Pancreas: A Single-Center Experience.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Yue Tiffany M, Sun Beatrice J, Delitto Daniel J, Dua Monica M, Norton Jeffrey A, Poultsides George A, Visser Brendan C, Lee Byrne
Аннотация
INTRODUCTION: Solid pseudopapillary neoplasms (SPNs) are rare tumors of the pancreas that are typically low-grade but may carry malignant potential. While concurrent splenectomy is recommended for oncologic resection of malignant distal pancreas tumors, this is not well-described for SPN. This study evaluates the outcomes of spleen preservation for distal pancreas SPN.
METHODS: A retrospective review was conducted for adult patients with SPN who underwent surgical resection at a single tertiary center (2010-2023). Distal tumors were located within the pancreatic body or tail. Patient factors and outcomes were compared between those who underwent spleen-preserving (SP) versus nonspleen-preserving (NSP) distal pancreatectomy.
RESULTS: In total, 52 patients underwent surgery for SPN. Thirty six had localized distal pancreatic tumors and underwent distal/subtotal pancreatectomy: 25 (69%) were SP and 11 (31%) were NSP. Overall, median age was 31 y, 86% were female, and 61% were symptomatic at diagnosis. Median tumor size (4.9 cm SP versus 6.0 cm NSP, P = 0.469) and number of lymph nodes examined (6 SP versus 11 NSP, P = 0.241) were similar. The majority of SP operations were completed minimally invasively via laparoscopic or robotic approaches (84% SP versus 36% NSP, P = 0.008). There was no difference in operative time, complications, length of stay, or readmission between groups. Neither cohort had recurrence of SPN at median follow-up of 3 y.
CONCLUSIONS: SP pancreatectomy can be performed safely for distal SPN with excellent long-term oncologic outcomes. This technique may be achieved minimally invasively and should be considered for localized SPN in the body or tail of the pancreas.
METHODS: A retrospective review was conducted for adult patients with SPN who underwent surgical resection at a single tertiary center (2010-2023). Distal tumors were located within the pancreatic body or tail. Patient factors and outcomes were compared between those who underwent spleen-preserving (SP) versus nonspleen-preserving (NSP) distal pancreatectomy.
RESULTS: In total, 52 patients underwent surgery for SPN. Thirty six had localized distal pancreatic tumors and underwent distal/subtotal pancreatectomy: 25 (69%) were SP and 11 (31%) were NSP. Overall, median age was 31 y, 86% were female, and 61% were symptomatic at diagnosis. Median tumor size (4.9 cm SP versus 6.0 cm NSP, P = 0.469) and number of lymph nodes examined (6 SP versus 11 NSP, P = 0.241) were similar. The majority of SP operations were completed minimally invasively via laparoscopic or robotic approaches (84% SP versus 36% NSP, P = 0.008). There was no difference in operative time, complications, length of stay, or readmission between groups. Neither cohort had recurrence of SPN at median follow-up of 3 y.
CONCLUSIONS: SP pancreatectomy can be performed safely for distal SPN with excellent long-term oncologic outcomes. This technique may be achieved minimally invasively and should be considered for localized SPN in the body or tail of the pancreas.