title: One hundred thirty resections for pancreatic neuroendocrine tumor: evaluating the impact of minimally invasive and parenchyma-sparing techniques.
abstract: BACKGROUND
  Increasingly, surgeons apply minimally invasive and parenchyma-sparing techniques to the management of pancreatic neuroendocrine tumor (PNET). The aim of this study was to evaluate the impact of these approaches on patient outcomes.
  
  
  METHODS
  We retrospectively collected data on patients with PNET and compared perioperative and pathologic variables. Survival was analyzed using the Kaplan-Meier method. Factors influencing survival were evaluated using a Cox proportional hazards model.
  
  
  RESULTS
  One hundred thirty patients underwent resection for PNET. Traditional resections included 43 pancreaticoduodenectomies (PD), 38 open distal pancreatectomies (DP), and four total pancreatectomies. Minimally invasive and parenchyma-sparing resections included 25 laparoscopic DP, 11 central pancreatectomies, five enucleations, three partial pancreatectomies, and one laparoscopic-assisted PD. Compared to traditional resections, the minimally invasive and parenchyma-sparing resections had shorter hospital stays. By univariate analysis of neuroendocrine carcinoma, liver metastases and positive resection margins correlated with poor survival. There was an increase in minimally invasive or parenchyma-sparing resections over the study period with no differences in morbidity, mortality, or survival.
  
  
  CONCLUSIONS
  In this series, there has been a significant increase in minimally invasive and parenchyma-sparing techniques for PNET. This shift did not increase morbidity or compromise survival. In addition, minimally invasive and parenchyma-sparing operations yielded shorter hospital stays.
authors.affiliation: College of Physicians and Surgeons, Department of Surgery, Columbia University, 161 Fort Washington Avenue, Suite 820, New York, NY 10032, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: DiNorcia
authors.forename: Minna K
authors.initials: MK
authors.lastname: Lee
authors.forename: Patrick L
authors.initials: PL
authors.lastname: Reavey
authors.forename: Jeanine M
authors.initials: JM
authors.lastname: Genkinger
authors.forename: James A
authors.initials: JA
authors.lastname: Lee
authors.forename: Beth A
authors.initials: BA
authors.lastname: Schrope
authors.forename: John A
authors.initials: JA
authors.lastname: Chabot
authors.forename: John D
authors.initials: JD
authors.lastname: Allendorf
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D018358:Neuroendocrine Tumors / Q000601:surgery*; D010179:Pancreas / Q000601:surgery; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016896:Treatment Outcome
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