Robot-assisted spleen preserving pancreatic surgery in MEN1 patients.
BACKGROUND
Multiple Endocrine Neoplasia type 1 (MEN1) patients often undergo multiple pancreatic operations at a young age.


OBJECTIVE
To describe robot-assisted and laparoscopic spleen-preserving pancreatic surgery in MEN1 patients, and to compare both techniques.


METHODS
Robot-assisted pancreatectomies of the DutchMEN1 study group and the Université de Lorraine, Nancy, France were compared to a historical cohort of laparoscopic treated MEN1 patients. Perioperative outcomes were compared.


RESULTS
A total of 21 MEN1 patients underwent minimally invasive pancreatic surgery for pancreatic neuroendocrine tumors, seven patients were subjected to robot-assisted surgery, and 14 patients underwent laparoscopic surgery. Demographics and clinical characteristics did not differ between the cohorts and no significant differences in operative outcomes were found. A high number of ISGPS grade B/C pancreatic fistulas were observed in both cohorts (38%), and no conversions were seen in the robot-assisted cohort (respectively 0% vs. 43%, P = 0.06). In one laparoscopic and one robot-assisted case the primary tumor was not resected.


CONCLUSIONS
Minimally invasive spleen-preserving surgery in MEN1 patients is safe and feasible. Patients who underwent robot-assisted surgery did not require conversion to open surgery. J. Surg. Oncol. 2016;114:456-461. © 2016 Wiley Periodicals, Inc.
Department of Endocrine Surgical Oncology and Endocrine Oncology, University Medical Center Utrecht, Utrecht, The Netherlands.
Sjoerd
S
Nell
Department of Digestive, Hepatobiliary and Endocrine Surgery, Université de Lorraine, Hôpital Brabois Adultes, CHU Nancy, Nancy, France.
Laurent
L
Brunaud
Department of Digestive, Hepatobiliary and Endocrine Surgery, Université de Lorraine, Hôpital Brabois Adultes, CHU Nancy, Nancy, France.
Ahmet
A
Ayav
Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Bert A
BA
Bonsing
Department of Surgery, Erasmus Medical Center, Rotterdam, The Netherlands.
Bas
B
Groot Koerkamp
Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
Els J
EJ
Nieveen van Dijkum
Department of Surgery, VU University Medical Center, Amsterdam, The Netherlands.
Geert
G
Kazemier
Department of Hepatobiliary Surgery and Liver Transplantation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Ruben H J
RH
de Kleine
Department of Surgical Oncology and Hepato-Pancreato-Biliary Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
Jeroen
J
Hagendoorn
Department of Surgical Oncology and Hepato-Pancreato-Biliary Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
I Quintus
IQ
Molenaar
Department of Endocrine Oncology, University Medical Center Utrecht, Utrecht, The Netherlands.
Gerlof D
GD
Valk
Department of Surgical Oncology and Endocrine Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands.
Inne H M
IH
Borel Rinkes
Department of Endocrine Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands.
Menno R
MR
Vriens
D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D018761:Multiple Endocrine Neoplasia Type 1 / Q000601:surgery*; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000601:surgery*; D065287:Robotic Surgical Procedures / Q000379:methods*; D013154:Spleen / Q000601:surgery*
laparoscopic pancreatic surgery; multiple endocrine neoplasia type 1; neuroendocrine tumors; pancreas; robot-assisted pancreatic surgery