Page 10 - Read Online

Kauffmann et al. Mini-invasive Surg 2020;4:54 I http://dx.doi.org/10.20517/2574-1225.2020.46 Page 5 of 10

Table 3. Post-operative outcome measures
Result
Median length of hospital stay (days) (IQR) 10 (8-13)
Median CCI, n (IQR) 20.9 (0-20.9)
Postoperative complications, n (%)
Clavien-Dindo Grade 0 21 (38.9%)
Clavien-Dindo Grade I-II 32 (59.3%)
Clavien-Dindo Grade III-IV 1 (1.8%)
Post-operative blood transfusions, n (%) 5 (9.2%)
POPF, n (%) 27 (50%)
Grade BL, n (%) 8 (14.8%)
Grade B, n (%) 19 (35.2%)
Grade C, n (%) 0
Clinically relevant POPF, n (%) 19 (35.2%)
PPH, n (%) 1 (1.8%)
Grade A, n (%) 0
Grade B, n (%) 1 (1.8%)
Grade C, n (%) 0
DGE, n (%) 3 (5.5%)
Grade A, n (%) 1 (1.8%)
Grade B, n (%) 2 (3.7%)
Grade C, n (%) 0
Reoperation, n (%) 2 (3.7%)
Readmission, n (%) 4 (7.4%)
CCI: comprehensive complication index; POPF: postoperative pancreatic fistula; DGE: Delayed
gastric emptying; PPH: post-pancreatectomy hemorrage

re-operated during the initial hospital stay, the bleeding was controlled, and the spleen was preserved. The
second patient was re-operated at the time of hospital readmission. Overall, the median Comprehensive
Complication Index was 20.9 (IQR: 0-20.9). Second, there were no grade C POPF, despite grade B POPF
was observed in 19 patients (35.2%). Third, four patients were readmitted (7.4%).

Tumor types are reported in Table 4.

Median tumor size was 26 mm IQR: (20-40). Excluding a patient with known diagnosis of metastasis from
renal cell carcinoma, 53 patients were scheduled for RA-SPDP for tumors presumed to be benign, or not
overtly malignant. Malignancy was instead discovered in 7 patients (13.2%) [Table 5].

There were no cases of margin positivity (at 1 mm), in the group of patients with malignant tumors, and
the mean number of examined lymph nodes was 13.2 ± 12.3. Lymph nodes were positive in 3 patients
with neuroendocrine cancer. Among a group of 10 patients with intraductal mucinous papillary tumors
[22]
(IPMN) and worrisome features , two were found to be overtly malignant and of pancreatobiliary type.
In one of these patients the tumor was in-situ. In the other patient showed focal infiltration of pancreatic
parenchyma (T1). This patient was re-operated three months after the initial surgery to receive splenectomy
and completion of the procedure according to oncologic principles. Repeat surgery was performed again
using a robotic approach. Additional tissues removed showed no residual malignant growths either in the
segment pancreatic body left behind at the initial surgery or in 22 retrieved lymph nodes.

After a mean follow-up period of 48.6 ± 30.6 months no patient developed evidence of either tumor
recurrence (for those with a malignant histology) or splenic vein thrombosis (excluding the patient who
required splenectomy due to splenic infarction).