Yıl: 2019 Cilt: 53 Sayı: 2 Sayfa Aralığı: 114 - 119 Metin Dili: İngilizce DOI: 10.14744/SEMB.2019.37880 İndeks Tarihi: 24-06-2020

Comparison of Clinical Outcomes of Single-Incision Versus Conventional Multiport Laparoscopic Distal Pancreatectomy: A Single Institution Experience

Öz:
Objectives: Single-incision laparoscopic procedures have been gaining popularity in recent years due to their minimal incisionalmorbidity and improved cosmetic outcomes. Herein, we will compare the feasibility and outcomes of single-incision and conventional multiport laparoscopic distal pancreatectomy.Methods: This study involves consecutive patients who underwent either single-incision or conventional multiport laparoscopicdistal pancreatectomy from March 2007 to February 2014. The patients were divided into two groups, based on the surgical approach: single-incision laparoscopic surgery (Group 1) and conventional multiport laparoscopic surgery (Group 2). The parametersevaluated included estimated blood loss, operative time, postoperative pain, duration of hospital stay, complications, conversion,and final pathology.Results: There were a total of 20 patients, 10 in each study group. Baseline characteristics were similar, and there was no mortalityin either of the groups. The low-flow pancreatic fistula was the most commonly seen morbidity, but it was ceased spontaneouslyin each group by a ratio of 30%. The operative time was significantly shorter in Group 2, with a mean of 116 minutes versus a meanof 180 minutes for Group 1 (p<0.001). One of the procedures in Group 2 was converted to open surgery due to peroperative bleeding. The median follow-up periods of the patients were 22 months and 56 months. The spleen was preserved in only 1 patient fromGroup 1, whereas in Group 2, the spleen preservation was achieved in 5 patients.Conclusion: The single-incision laparoscopic technique is a safe and effective alternative to standard laparoscopic distal pancreatectomy
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Gagner M, Pomp A. Laparoscopic pylorus-preserving pancreatoduodenectomy. Surg Endosc 1994;8:408–10.
  • 2. DiNorcia J, Schrope BA, Lee MK, Reavey PL, Rosen SJ, Lee JA, et al. Laparoscopic distal pancreatectomy offers shorter hospital stays with fewer complications. J Gastrointest Surg 2010;14:1804–12.
  • 3. Palanivelu C, Shetty R, Jani K, Sendhilkumar K, Rajan PS, Maheshkumar GS. Laparoscopic distal pancreatectomy: results of a prospective non-randomized study from a tertiary center. Surg Endosc 2007;21:373–7.
  • 4. Kooby DA, Gillespie T, Bentrem D, Nakeeb A, Schmidt MC, Merchant NB, et al. Left-sided pancreatectomy: a multicenter comparison of laparoscopic and open approaches. Ann Surg 2008;248:438–46.
  • 5. Navarra G, Pozza E, Occhionorelli S, Carcoforo P, Donini I. Onewound laparoscopic cholecystectomy. Br J Surg 1997;84:695.
  • 6. Barbaros U, Dinççağ A. Single incision laparoscopic splenectomy: the first two cases. J Gastrointest Surg 2009;13:1520–3.
  • 7. Kong J, Wu SD, Su Y. Translumenal single-incision laparoscopy radical gastrectomy with D2 lymph node dissection for early gastric cancer-primary experience with less invasive surgery in China. J Laparoendosc Adv Surg Tech A 2013;23:141–5.
  • 8. Cho CS, Kooby DA, Schmidt CM, Nakeeb A, Bentrem DJ, Merchant NB, et al. Laparoscopic versus open left pancreatectomy: can preoperative factors indicate the safer technique? Ann Surg 2011;253:975–80.
  • 9. Barbaros U, Sümer A, Demirel T, Karakullukçu N, Batman B, Içscan Y, et al. Single incision laparoscopic pancreas resection for pancreatic metastasis of renal cell carcinoma. JSLS 2010;14:566–70.
  • 10. Soper NJ, Brunt LM, Dunnegan DL, Meininger TA. Laparoscopic distal pancreatectomy in the porcine model. Surg Endosc 1994;8:57–60.
  • 11. Cuschieri SA, Jakimowicz JJ. Laparoscopic pancreatic resections. Semin Laparosc Surg 1998;5:168–79.
  • 12. Kooby DA, Chu CK. Laparoscopic management of pancreatic malignancies. Surg Clin North Am 2010;90:427–46.
  • 13. Fisichella PM, Shankaran V, Shoup M. Laparoscopic distal pancreatectomy with or without splenectomy: how I do it. J Gastrointest Surg 2011;15:215–8.
  • 14. Yao D, Wu S, Tian Y, Fan Y, Kong J, Li Y. Transumbilical single-incision laparoscopic distal pancreatectomy: primary experience and review of the English literature. World J Surg 2014;38:1196–204.
  • 15. Chang SK, Lomanto D, Mayasari M. Single-port laparoscopic spleen preserving distal pancreatectomy. Minim Invasive Surg 2012;2012:197429.
  • 16. Srikanth G, Shetty N, Dubey D. Single incision laparoscopic distal pancreatectomy with splenectomy for neuroendocrine tumor of the tail of pancreas. J Minim Access Surg 2013;9:132–5.
  • 17. Pierce RA, Spitler JA, Hawkins WG, Strasberg SM, Linehan DC, Halpin VJ, et al. Outcomes analysis of laparoscopic resection of pancreatic neoplasms. Surg Endosc 2007;21:579–86.
  • 18. Ayav A, Bresler L, Brunaud L, Boissel P; SFCL (Société Française de Chirurgie Laparoscopique); AFCE (Association Francophone de Chirurgie Endocrinienne). Laparoscopic approach for solitary insulinoma: a multicentre study. Langenbecks Arch Surg 2005;390:134–40.
  • 19. Spitz JD, Lilly MC, Tetik C, Arregui ME. Ultrasound-guided laparoscopic resection of pancreatic islet cell tumors. Surg Laparosc Endosc Percutan Tech 2000;10:168–73.
  • 20. Kooby DA, Hawkins WG, Schmidt CM, Weber SM, Bentrem DJ, Gillespie TW, et al. A multicenter analysis of distal pancreatectomy for adenocarcinoma: is laparoscopicresection appropriate? J Am Coll Surg 2010;210:779–85.
  • 21. Shoup M, Conlon KC, Klimstra D, Brennan MF. Is extended resection for adenocarcinoma of the body or tail of the pancreas justified? J Gastrointest Surg 2003;7:946–52.
  • 22. Song KB, Kim SC, Park JB, Kim YH, Jung YS, Kim MH, et al. Singlecenter experience of laparoscopic left pancreatic resection in 359 consecutive patients: changing the surgical paradigm of left pancreatic resection. Surg Endosc 2011;25:3364–72.
  • 23. Taylor C, O'Rourke N, Nathanson L, Martin I, Hopkins G, Layani L, et al. Laparoscopic distal pancreatectomy: the Brisbane experience of forty-six cases. HPB (Oxford) 2008;10:38–42.
  • 24. Warshaw AL. Conservation of the spleen with distal pancreatectomy. Arch Surg 1988;123:550–3.
  • 25. Lee SE, Jang JY, Lee KU, Kim SW. Clinical comparison of distal pancreatectomy with or without splenectomy. J Korean Med Sci 2008;23:1011–4.
  • 26. Richardson DQ, Scott-Conner CE. Distal pancreatectomy with and without splenectomy. A comparative study. Am Surg 1989;55:21–5.
  • 27. Aldridge MC, Williamson RC. Distal pancreatectomy with and without splenectomy. Br J Surg 1991;78:976–9.
  • 28. Thomsen SK, Green DJ. Predator-mediated effects of severe drought associated with poor reproductive success of a seabird in a cross-ecosystem cascade. Glob Chang Biol 2019;25:1642–52.
  • 29. Takeuchi K, Tsuzuki Y, Ando T, Sekihara M, Hara T, Kori T, et al. Distal pancreatectomy: is staple closure beneficial? ANZ J Surg 2003;73:922–5.
APA AGCAOGLU O, aksakal n, Azamat İ, DOĞAN S, MERCAN S, Barbaros U (2019). Comparison of Clinical Outcomes of Single-Incision Versus Conventional Multiport Laparoscopic Distal Pancreatectomy: A Single Institution Experience. , 114 - 119. 10.14744/SEMB.2019.37880
Chicago AGCAOGLU ORHAN,aksakal nihat,Azamat İbrahim Fethi,DOĞAN Selim,MERCAN Selçuk,Barbaros Umut Comparison of Clinical Outcomes of Single-Incision Versus Conventional Multiport Laparoscopic Distal Pancreatectomy: A Single Institution Experience. (2019): 114 - 119. 10.14744/SEMB.2019.37880
MLA AGCAOGLU ORHAN,aksakal nihat,Azamat İbrahim Fethi,DOĞAN Selim,MERCAN Selçuk,Barbaros Umut Comparison of Clinical Outcomes of Single-Incision Versus Conventional Multiport Laparoscopic Distal Pancreatectomy: A Single Institution Experience. , 2019, ss.114 - 119. 10.14744/SEMB.2019.37880
AMA AGCAOGLU O,aksakal n,Azamat İ,DOĞAN S,MERCAN S,Barbaros U Comparison of Clinical Outcomes of Single-Incision Versus Conventional Multiport Laparoscopic Distal Pancreatectomy: A Single Institution Experience. . 2019; 114 - 119. 10.14744/SEMB.2019.37880
Vancouver AGCAOGLU O,aksakal n,Azamat İ,DOĞAN S,MERCAN S,Barbaros U Comparison of Clinical Outcomes of Single-Incision Versus Conventional Multiport Laparoscopic Distal Pancreatectomy: A Single Institution Experience. . 2019; 114 - 119. 10.14744/SEMB.2019.37880
IEEE AGCAOGLU O,aksakal n,Azamat İ,DOĞAN S,MERCAN S,Barbaros U "Comparison of Clinical Outcomes of Single-Incision Versus Conventional Multiport Laparoscopic Distal Pancreatectomy: A Single Institution Experience." , ss.114 - 119, 2019. 10.14744/SEMB.2019.37880
ISNAD AGCAOGLU, ORHAN vd. "Comparison of Clinical Outcomes of Single-Incision Versus Conventional Multiport Laparoscopic Distal Pancreatectomy: A Single Institution Experience". (2019), 114-119. https://doi.org/10.14744/SEMB.2019.37880
APA AGCAOGLU O, aksakal n, Azamat İ, DOĞAN S, MERCAN S, Barbaros U (2019). Comparison of Clinical Outcomes of Single-Incision Versus Conventional Multiport Laparoscopic Distal Pancreatectomy: A Single Institution Experience. Şişli Etfal Hastanesi Tıp Bülteni, 53(2), 114 - 119. 10.14744/SEMB.2019.37880
Chicago AGCAOGLU ORHAN,aksakal nihat,Azamat İbrahim Fethi,DOĞAN Selim,MERCAN Selçuk,Barbaros Umut Comparison of Clinical Outcomes of Single-Incision Versus Conventional Multiport Laparoscopic Distal Pancreatectomy: A Single Institution Experience. Şişli Etfal Hastanesi Tıp Bülteni 53, no.2 (2019): 114 - 119. 10.14744/SEMB.2019.37880
MLA AGCAOGLU ORHAN,aksakal nihat,Azamat İbrahim Fethi,DOĞAN Selim,MERCAN Selçuk,Barbaros Umut Comparison of Clinical Outcomes of Single-Incision Versus Conventional Multiport Laparoscopic Distal Pancreatectomy: A Single Institution Experience. Şişli Etfal Hastanesi Tıp Bülteni, vol.53, no.2, 2019, ss.114 - 119. 10.14744/SEMB.2019.37880
AMA AGCAOGLU O,aksakal n,Azamat İ,DOĞAN S,MERCAN S,Barbaros U Comparison of Clinical Outcomes of Single-Incision Versus Conventional Multiport Laparoscopic Distal Pancreatectomy: A Single Institution Experience. Şişli Etfal Hastanesi Tıp Bülteni. 2019; 53(2): 114 - 119. 10.14744/SEMB.2019.37880
Vancouver AGCAOGLU O,aksakal n,Azamat İ,DOĞAN S,MERCAN S,Barbaros U Comparison of Clinical Outcomes of Single-Incision Versus Conventional Multiport Laparoscopic Distal Pancreatectomy: A Single Institution Experience. Şişli Etfal Hastanesi Tıp Bülteni. 2019; 53(2): 114 - 119. 10.14744/SEMB.2019.37880
IEEE AGCAOGLU O,aksakal n,Azamat İ,DOĞAN S,MERCAN S,Barbaros U "Comparison of Clinical Outcomes of Single-Incision Versus Conventional Multiport Laparoscopic Distal Pancreatectomy: A Single Institution Experience." Şişli Etfal Hastanesi Tıp Bülteni, 53, ss.114 - 119, 2019. 10.14744/SEMB.2019.37880
ISNAD AGCAOGLU, ORHAN vd. "Comparison of Clinical Outcomes of Single-Incision Versus Conventional Multiport Laparoscopic Distal Pancreatectomy: A Single Institution Experience". Şişli Etfal Hastanesi Tıp Bülteni 53/2 (2019), 114-119. https://doi.org/10.14744/SEMB.2019.37880