Vessel-Sparing Lymphadenectomy Should Be Performed in Small Intestine Neuroendocrine Neoplasms
Introduction: The goal of primary tumor resection with lymphadenectomy (PTR) in small intestine neuroendocrine neoplasms (SI-NENs) is to avoid local recurrence while sparing as much of the small bowel as possible, even in the case of extensive mesenteric fibrosis. The results of PTR with retrograde...
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MDPI AG
2022-07-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/15/3610 |
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| author | Detlef K. Bartsch Sebastian Windel Veit Kanngießer Moritz Jesinghaus Katharina Holzer Anja Rinke Elisabeth Maurer |
| author_facet | Detlef K. Bartsch Sebastian Windel Veit Kanngießer Moritz Jesinghaus Katharina Holzer Anja Rinke Elisabeth Maurer |
| author_sort | Detlef K. Bartsch |
| collection | DOAJ |
| description | Introduction: The goal of primary tumor resection with lymphadenectomy (PTR) in small intestine neuroendocrine neoplasms (SI-NENs) is to avoid local recurrence while sparing as much of the small bowel as possible, even in the case of extensive mesenteric fibrosis. The results of PTR with retrograde vessel-sparing lymphadenectomy (VS-LA) were compared to those of conventional lymphadenectomy (Con-LA). Methods: Prospectively collected clinical, surgical and pathological data of consecutive patients with SI-NENs who underwent small bowel resections were retrospectively analyzed regarding the resection technique performed. Results: In a 7-year period, 50 of 102 patients with SI-NENs had only small bowel resections; of those, 25 were VS-LA and 25 were Con-LA. Patients with VS-LA had tendentially more advanced diseases with slightly higher rates of abdominal pain, mesenteric shrinkage and more level III lymph node involvement compared to patients with Con-LA. VS-LA, however, resulted in shorter resected bowel segments (median 40 cm vs. 65 cm, <i>p</i> = 0.007) with similar rates of local R0 resections (72% vs. 84%) and resected lymph nodes (median 13 vs. 13). Postoperative clinically relevant complications occurred in 1 of 25 (4%) in the VS-LA and in 7 of 25 (28%) patients in the Con-LA group (<i>p</i> = 0.02). Three months after surgery, 1 of 25 (4%) patients of the VS-LA group and 10 of 25 (40%) patients in the Con-LA group (<i>p</i> = 0.002) complained about abdominal pain. One of eight patients in the VS-LA group and two of thirteen patients in the Con-LA group who had completely resected stage III disease complained about diarrhea (<i>p</i> = 0.31). Conclusion: VS-LA seems to be oncologically safe and should be considered in small bowel resections for SI-NENs. |
| first_indexed | 2024-03-09T12:44:46Z |
| format | Article |
| id | doaj.art-4fe998971582452f946ddc0951334bde |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T12:44:46Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-4fe998971582452f946ddc0951334bde2023-11-30T22:13:12ZengMDPI AGCancers2072-66942022-07-011415361010.3390/cancers14153610Vessel-Sparing Lymphadenectomy Should Be Performed in Small Intestine Neuroendocrine NeoplasmsDetlef K. Bartsch0Sebastian Windel1Veit Kanngießer2Moritz Jesinghaus3Katharina Holzer4Anja Rinke5Elisabeth Maurer6Department of Visceral-, Thoracic- and Vascular Surgery, Philipps-University Marburg, Baldingerstraße, 35043 Marburg, GermanyDepartment of Visceral-, Thoracic- and Vascular Surgery, Philipps-University Marburg, Baldingerstraße, 35043 Marburg, GermanyDepartment of Visceral-, Thoracic- and Vascular Surgery, Philipps-University Marburg, Baldingerstraße, 35043 Marburg, GermanyInstitute of Pathology, Philipps-University Marburg, Baldingerstraße, 35043 Marburg, GermanyDepartment of Visceral-, Thoracic- and Vascular Surgery, Philipps-University Marburg, Baldingerstraße, 35043 Marburg, GermanyDepartment of Gastroenterology and Endocrinology, Philipps-University Marburg, Baldingerstraße, 35043 Marburg, GermanyDepartment of Visceral-, Thoracic- and Vascular Surgery, Philipps-University Marburg, Baldingerstraße, 35043 Marburg, GermanyIntroduction: The goal of primary tumor resection with lymphadenectomy (PTR) in small intestine neuroendocrine neoplasms (SI-NENs) is to avoid local recurrence while sparing as much of the small bowel as possible, even in the case of extensive mesenteric fibrosis. The results of PTR with retrograde vessel-sparing lymphadenectomy (VS-LA) were compared to those of conventional lymphadenectomy (Con-LA). Methods: Prospectively collected clinical, surgical and pathological data of consecutive patients with SI-NENs who underwent small bowel resections were retrospectively analyzed regarding the resection technique performed. Results: In a 7-year period, 50 of 102 patients with SI-NENs had only small bowel resections; of those, 25 were VS-LA and 25 were Con-LA. Patients with VS-LA had tendentially more advanced diseases with slightly higher rates of abdominal pain, mesenteric shrinkage and more level III lymph node involvement compared to patients with Con-LA. VS-LA, however, resulted in shorter resected bowel segments (median 40 cm vs. 65 cm, <i>p</i> = 0.007) with similar rates of local R0 resections (72% vs. 84%) and resected lymph nodes (median 13 vs. 13). Postoperative clinically relevant complications occurred in 1 of 25 (4%) in the VS-LA and in 7 of 25 (28%) patients in the Con-LA group (<i>p</i> = 0.02). Three months after surgery, 1 of 25 (4%) patients of the VS-LA group and 10 of 25 (40%) patients in the Con-LA group (<i>p</i> = 0.002) complained about abdominal pain. One of eight patients in the VS-LA group and two of thirteen patients in the Con-LA group who had completely resected stage III disease complained about diarrhea (<i>p</i> = 0.31). Conclusion: VS-LA seems to be oncologically safe and should be considered in small bowel resections for SI-NENs.https://www.mdpi.com/2072-6694/14/15/3610small intestine neuroendocrine neoplasmsprimary tumor resectionlymphadenectomyvessel-sparing |
| spellingShingle | Detlef K. Bartsch Sebastian Windel Veit Kanngießer Moritz Jesinghaus Katharina Holzer Anja Rinke Elisabeth Maurer Vessel-Sparing Lymphadenectomy Should Be Performed in Small Intestine Neuroendocrine Neoplasms Cancers small intestine neuroendocrine neoplasms primary tumor resection lymphadenectomy vessel-sparing |
| title | Vessel-Sparing Lymphadenectomy Should Be Performed in Small Intestine Neuroendocrine Neoplasms |
| title_full | Vessel-Sparing Lymphadenectomy Should Be Performed in Small Intestine Neuroendocrine Neoplasms |
| title_fullStr | Vessel-Sparing Lymphadenectomy Should Be Performed in Small Intestine Neuroendocrine Neoplasms |
| title_full_unstemmed | Vessel-Sparing Lymphadenectomy Should Be Performed in Small Intestine Neuroendocrine Neoplasms |
| title_short | Vessel-Sparing Lymphadenectomy Should Be Performed in Small Intestine Neuroendocrine Neoplasms |
| title_sort | vessel sparing lymphadenectomy should be performed in small intestine neuroendocrine neoplasms |
| topic | small intestine neuroendocrine neoplasms primary tumor resection lymphadenectomy vessel-sparing |
| url | https://www.mdpi.com/2072-6694/14/15/3610 |
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