Clinical study of robot and laparoscopic minimally invasive surgery for well-differentiated pancreatic neuroendocrine tumors

Abstract

Background and purpose: Pancreatic neuroendocrine tumor (pNET) is a rare tumor. At present, there is still a lack of large-scale clinical research data to summarize the clinical effect of minimally invasive technology in the treatment of pNET. This study analyzed the clinical data of pNET patients undergoing surgical treatment, in order to provide reference for the surgical treatment of pNET. Methods: The clinical data of 118 patients with well-differentiated pNET undergoing minimally invasive surgery admitted by the Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center from September 2018 to July 2022 were retrospectively analyzed. The patients were divided into robot group (n=17) and laparoscopic group (n=101) according to the minimally invasive operation mode. According to the surgical resection mode, they were divided into regular resection group (n=86) and local resection group (n=32). The clinical data of operation and postoperation were collected and analyzed. Results: Of the 118 patients who underwent minimally invasive surgery on pNET included in this study, 17 were in the robot group, and 101 were in the laparoscopic group. There were 32 cases in local resection group and 86 cases in regular resection group. There was no significant difference between robot group and laparoscopic group in operation time and intraoperative bleeding (P>0.05). The operation time of local resection group [(145.3±55.5) min] was significantly shorter compared with regular resection group [(247.4±94.7) min](P <0.05). At the same time, the bleeding volume [(71.8±23.2) mL] was significantly less in the local resection group than in the regular resection group [(147.5±59.9) mL](P<0.05). The recovery of gastrointestinal function in the robot group was earlier compared with laparoscopic group (P<0.05). There was no significant difference between the two groups in terms of postoperative ambulatory time, postoperative pancreatic fistula, delayed gastric emptying, postoperative effusion and postoperative hospitalization time (P>0.05). The incidence of postoperative b-pancreatic fistula was higher in the local resection group than in the regular resection group (P<0.05), and the postoperative hospital stay was significantly longer in the local resection group than in the regular resection group (P<0.05). Conclusion: Minimally invasive surgery is safe and feasible to treat well-differentiated pNET. There was no significant difference in minimally invasive effect between laparoscope and robot. The incidence of pancreatic fistula after local resection of tumor is higher, and the postoperative hospital stay is longer, however the long-term benefit is expected.

Keywords

• |pancreatic neuroendocrine tumor|minimally invasive surgery|robotic surgery|local excision of tumor|function-preserving operation