Solid-pseudopapillary Neoplasm Of The Pancreas:Case Review And Summary Of Clinical Experiences

Aim To discuss the clinical diagnosis and treatment experiences of solid-pseudopapillary neoplasm(SPN)of pancreas from our single center;to compare the surgical and post-operational parameters between Da Vinci robotic surgery and traditional open surgery in treating SPN.Methods This study collected a total of 152 SPN cases confirmed by pathological diagnoses post operation from January 1996 to January 2005.We reviewed the history,clinical characteristics and surgical approach of these cases,retrospectively.From these SPN cases,the traditional surgeries were compared with Da Vinci Robotic System assisted surgeries on the intra-operational and post-operational parameters.The continuous variables were analyzed using one-way analysis of variance(ANOVA)and multivariate linear regression.Whereas the categorical variables were analyzed using Chi-square test and Logistic regression.P-value less than 0.05 was defined as statistically significant.All statistical analyses were conducted using SPSS ver 19.0.Results This study included 20 males and 132 females SPN patients.The median age was 31 years old.The most common location of SPN was found in the pancreatic body or tail(48.1%).The most common chief complaint was incident finding of space-occupying lesion of pancreas(69 cases,45.4%).Surgical approach was decided by tumor location(P < 0.001)and tumor size(P = 0.009).Compared with traditional open surgeries,the Da Vinci Robotic System assisted surgeries had significant strengths in intra-operational time and blood loss(P < 0.001 and P = 0.048,respectively).However,the robotic system did not differ from traditional surgeries in terms of total hospital stay(P = 0.135),post-operational hospital stay(P = 0.133),or the risk of post-operational complications(P = 0.169;all conducted by Logistic regression).The results also indicate that the risk factors contributing to post-operational complication included gender(P = 0.022),the location of tumor(P = 0.022),intra-operational time(P = 0.013)and blood loss(P = 0.004).Moreover,patients experienced robotic-assisted surgery had significantly lower white blood cells count post-operationally(P = 0.047).Discussion Solid-pseudopapillary neoplasm of pancreas is a type of low-grade malignancy more prevalent in young women.The most common lesion is located in the body and tail of pancreas.Patients often have no typical clinical symptoms.Surgical resection is the main treatment.Surgical technique depends on the size and location of the tumor.Compared with traditional open surgeries,the Da Vinci Robotic System assisted surgeries showed significant strengths in intra-operational time,blood loss as well as lower post-operational white blood cells count.