title: Laparoscopic vs open distal pancreatectomy for solid pseudopapillary tumor of the pancreas.
abstract: OBJECTIVE
  To compare short- and long-term outcomes of laparoscopic vs open distal pancreatectomy for solid pseudopapillary tumor (SPT) of the pancreas.
  
  
  METHODS
  This retrospective study included 28 patients who underwent distal pancreatectomy for SPT of the pancreas between 1998 and 2012. The patients were divided into two groups based on the surgical approach: the laparoscopic surgery group and the open surgery group. The patients' demographic data, operative results, pathological reports, hospital courses, morbidity and mortality, and follow-up data were compared between the two groups.
  
  
  RESULTS
  Fifteen patients with SPT of the pancreas underwent laparoscopic distal pancreatectomy (LDP), and 13 underwent open distal pancreatectomy (ODP). Baseline characteristics were similar between the two groups except for a female predominance in the LDP group (100.0% vs 69.2%, P = 0.035). Mortality, morbidity (33.3% vs 38.5%, P = 1.000), pancreatic fistula rates (26.7% vs 30.8%, P = 0.728), and reoperation rates (0.0% vs 7.7%, P = 0.464) were similar in the two groups. There were no significant differences in the operating time (171 min vs 178 min, P = 0.755) between the two groups. The intraoperative blood loss (149 mL vs 580 mL, P = 0.002), transfusion requirement (6.7% vs 46.2%, P = 0.029), first flatus time (1.9 d vs 3.5 d, P = 0.000), diet start time (2.3 d vs 4.9 d, P = 0.000), and postoperative hospital stay (8.1 d vs 12.8 d, P = 0.029) were significantly less in the LDP group than in the ODP group. All patients had negative surgical margins at final pathology. There were no significant differences in number of lymph nodes harvested (4.6 vs 6.4, P = 0.549) between the two groups. The median follow-up was 33 (3-100) mo for the LDP group and 45 (17-127) mo for the ODP group. All patients were alive with one recurrence.
  
  
  CONCLUSIONS
  LDP for SPT has short-term benefits compared with ODP. Long-term outcomes of LDP are similar to those of ODP.
authors.affiliation: Ren-Chao Zhang, Jia-Fei Yan, Xiao-Wu Xu, Ke Chen, Harsha Ajoodhea, Yi-Ping Mou, Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China.
authors.forename: Ren-Chao
authors.initials: RC
authors.lastname: Zhang
authors.forename: Jia-Fei
authors.initials: JF
authors.lastname: Yan
authors.forename: Xiao-Wu
authors.initials: XW
authors.lastname: Xu
authors.forename: Ke
authors.initials: K
authors.lastname: Chen
authors.forename: Harsha
authors.initials: H
authors.lastname: Ajoodhea
authors.forename: Yi-Ping
authors.initials: YP
authors.lastname: Mou
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001803:Blood Transfusion; D002291:Carcinoma, Papillary / Q000401:mortality / Q000601:surgery*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000401:mortality; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000601:surgery*; D020127:Recovery of Function; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Distal pancreatectomy; Laparoscopic surgery; Pancreatic tumor; Solid pseudopapillary tumor