Laparoscopic versus open distal splenopancreatectomy for the treatment of pancreatic body and tail cancer: a retrospective, mid-term follow-up study at a single academic tertiary care institution.
OBJECTIVE
Laparoscopic distal splenopancreatectomy (DSP) is an effective and safe surgical modality for treating benign and borderline distal pancreatic tumors, but rarely for pancreatic cancer. This study aimed to examine the feasibility, effectiveness, and safety of laparoscopic versus laparotomic DSP in pancreatic body-tail cancer (PBTC) patients.


METHODS
Thirty-four PBTC patients were consecutively and retrospectively hospitalized for elective laparoscopic DSP (n = 11) or laparotomy (n = 23) between January 2007 and December 2011. The primary outcome measure was mean overall survival (OS).


RESULTS
All patients underwent DSP via laparoscopy or laparotomy as scheduled and were followed-up for 12-72 months. The two groups showed statistically similar mean operative time (laparoscopy vs. laparotomy, 150 ± 54 vs. 160 ± 48 min), median volume of intraoperative bleeding (100 [50-400] vs. 150 [50-350] ml), and rate of postoperative pancreatic fistula (18.2 vs. 21.7 %). The laparoscopy group had a significantly shorter median duration of hospitalization (5 [3-12] vs. 8 [7-22] d, P < 0.05). All patients had a clear resection margin and showed statistically similar tumor size (2.8 ± 1.5 vs. 3.1 ± 1.7 cm), number of lymph nodes dissected (14.8 ± 4.5 vs. 16.1 ± 5.7), and mean OS (42.0 ± 8.6 vs. 54.0 ± 5.8 mo, P > 0.05).


CONCLUSIONS
Laparoscopic DSP is a feasible, effective, and safe alternative to laparotomy in carefully selected PBTC patients and is associated with a more rapid postoperative recovery.
Department of Surgical Oncology, The General Hospital of Chinese People's Liberation Army, Fu-xing Road 28, Beijing, 100853, China.
Minggen
M
Hu
Guodong
G
Zhao
Fei
F
Wang
Zhiming
Z
Zhao
Chenggang
C
Li
Rong
R
Liu
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy / Q000379:methods*; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D013534:Survival; D063128:Tertiary Health Care; D016896:Treatment Outcome