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KMID : 1152420180240020076
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Advances in Pediatric Surgery
2018 Volume.24 No. 2 p.76 ~ p.85
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Perioperative Outcomes and Surgical Indications of Minimally Invasive Pancreatectomy for Solid Pseudopapillary Tumor in Pediatric Patients
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Lee Chong-Won
Namgoong Jung-Man
Kim Dae-Yeon
Kim Seong-Chul
Lee Soo-Young
Cho Yu-Jeong
Kwon Hyun-Hee
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Abstract
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Purpose: We evaluated perioperative and long-term outcomes of minimally invasive surgery (MIS) and established indications of MIS in solid pseudopapillary tumor (SPT) in pediatric patients.
Methods: From October 1992 to April 2018, 66 patients (age, <18 years) diagnosed with SPT underwent either open pancreatectomy (OP) or MIS. Variables including postoperative complications and recurrence rates were retrospectively analyzed.
Results: Thirty-five patients underwent open surgery and 31 underwent laparoscopic/robotic surgery. Mean tumor size in MIS was significantly smaller than that in OP (4.3±1.8 cm vs. 7.6±3.5 cm, p=0.005). There were 4 cases of open conversion from laparoscopic surgery because of vessel encasements (n=2), bleeding (n=1), and pancreatic ductal injury (n=1). Solitary pseudopapillary carcinoma was diagnosed in 6 patients. Recurrence was observed in 3 and 1 patients who underwent OP and MIS, respectively (p=0.634). Tumor size, mass size/abdominal diameter (MS/AD) ratio, and degree of the portal or superior mesenteric vein involvement were the most important indications for MIS.
Conclusion: MIS is being widely used in pediatric surgeries with increased expertise and safety, especially in pancreatic diseases. Careful patient selection for MIS in regards with parameters such as MS/AD ratio and vessel abutment might be a feasible choice.
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KEYWORD
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Solid pseudopapillary tumor, Minimally invasive surgery, Laparoscopic surgery, Robotic surgical procedures
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