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Updated Meta-analysis of Minimally Invasive Versus Open Surgery for Pancreatic Neuroendocrine Neoplasms
Wei Zhang1, Jianwei Zhang1, Xu Che
1From the Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing.
Objectives:
The aim of this study was to compare the short-term and long-term outcomes of minimally invasive surgery (MIS) with those of open pancreas surgery (OPS) for the treatment of pancreatic neuroendocrine neoplasms (pNENs).
Methods:
Studies reporting the effects of MIS and OPS for pNENs, published on PubMed, Embase, and Cochrane Library before May 2020 were reviewed.
Results:
Seventeen cohort studies with a total of 1853 patients were eligible for analysis, including 655 patients in the MIS group and 1198 patients in the OPS group. The estimated blood loss, postoperative hospitalization time, overall complications, severe complications, spleen preservation, mortality, and recurrence in the MIS group were lower than those in the OPS group. The R0 rate, 3-year overall survival (OS), and 5-year OS in the MIS group were higher than those in the OPS group. There were no significant differences in operative time, postoperative pancreatic fistula, clinical postoperative pancreatic fistula, postoperative bleeding, reoperation, readmission, and 1-year OS.
Conclusions:
Minimally invasive surgery can reach lower recurrence rate, higher long-term survival rate, and better outcomes in terms of estimated blood loss, postoperative hospitalization time, R0 rate, mortality, overall complications, and severe complications for pNENs. More high quality studies need to be conducted for further verification.
Insights
Minimally invasive surgery (MIS) for pancreatic neuroendocrine neoplasms (pNENs) shows better short-term and long-term outcomes than open pancreas surgery (OPS). MIS offers lower recurrence and higher survival rates, with reduced complications and hospital stays.
Area of Science:
- Surgical Oncology
- Gastroenterology
- Medical Technology
Background:
- Pancreatic neuroendocrine neoplasms (pNENs) require effective surgical treatment.
- Comparing minimally invasive surgery (MIS) and open pancreas surgery (OPS) is crucial for optimizing patient outcomes.
Purpose of the Study:
- To compare short-term and long-term outcomes of MIS versus OPS for pNENs.
- To evaluate the efficacy and safety of different surgical approaches for pNENs.
Main Methods:
- Systematic review of cohort studies from PubMed, Embase, and Cochrane Library.
- Analysis of 17 studies involving 1853 patients (655 MIS, 1198 OPS).
Main Results:
- MIS group demonstrated lower estimated blood loss, shorter hospitalization, fewer overall and severe complications, and reduced recurrence rates.
- Higher R0 resection rates and improved 3-year and 5-year overall survival (OS) were observed in the MIS group.
- No significant differences were found in operative time, pancreatic fistula rates, bleeding, reoperation, readmission, or 1-year OS.
Conclusions:
- Minimally invasive surgery (MIS) is associated with superior outcomes for pNENs, including lower recurrence and higher survival.
- MIS offers advantages in blood loss, hospitalization time, R0 rate, mortality, and complication rates compared to open pancreas surgery (OPS).
- Further high-quality studies are recommended to validate these findings.
