Minimally Invasive Versus Open Resection for Solid Pseudopapillary Tumors of the Pancreas: A Propensity Score-Matched Analysis.

Background And Objectives: Solid pseudopapillary tumors (SPTs) of the pancreas occur predominantly in young females and possess low malignant potential. In this study, clinicopathologic, perioperative, and long-term outcomes are compared in SPT patients that received open or minimally invasive (MIS) resection.

Methods: The National Cancer Database (2010-2020) was queried to identify all patients with SPTs that underwent an open or MIS surgical resection. Propensity score matching analysis was conducted through 1:1 matching based on the nearest neighbor method.

Results: Of 835 patients, 59.7% received an open approach and 40.3% were performed MIS. Over the decade, MIS approach increased from 7.7% to 60.0% for distal pancreatectomy (DP) and 15.4% to 30.2% for pancreaticoduodenectomy (PD) (both p < 0.05). There were no differences in lymphadenectomy (>15 nodes) or resection margin positivity. Shorter length of stay was noted for MIS resections (PD: 5 vs. 8 days, p < 0.001; DP: 5 vs. 6 days, p = 0.022), and no difference was appreciated in 30-day readmission rates. There was no difference in overall survival between open and MIS approaches for PD and DP.

Conclusions: Minimally invasive resections for SPTs have increased by ~40% over a decade and may offer a safe and feasible alternative to open resection that provides similar perioperative and long-term oncologic outcomes.