International survey on opinions and use of minimally invasive surgery in small bowel neuroendocrine neoplasms
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(Published version)
Date
2022
Authors
Kaçmaz, E.
Engelsman, A.F.
Bemelman, W.A.
Tanis, P.J.
Nieveen van Dijkum, E.J.M.
Serrablo, A.
Proud, D.
Mackrill, D.
Toth, D.
Coetzee, E.
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Journal article
Citation
European Journal of Surgical Oncology, 2022; 48(6):1251-1257
Statement of Responsibility
Enes Kaçmaz, Anton F. Engelsman, Willem A. Bemelman, Pieter J. Tanis, Elisabeth J.M. Nieveen van Dijkum, on behalf of the International Study Group of Small bowel neuroendocrine neoplasm Surgery (ISGSS) (Authors List Alejandro Serrablo ... Hiddle M. Kroon ... et al.)
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Abstract
Introduction: Although minimally invasive surgery is becoming the standard technique in gastrointestinal surgery, implementation for small bowel neuroendocrine neoplasms (SB-NEN) is lagging behind. The aim of this international survey was to gain insights into attitudes towards minimally invasive surgery for resection of SB-NEN and current practices. Methods: An anonymous survey was sent to surgeons between February and May 2021 via (neuro) endocrine and colorectal societies worldwide. The survey consisted of questions regarding experience of the surgeon with minimally invasive SB-NEN resection and training. Results: A total of 58 responses from five societies across 20 countries were included. Forty-one (71%) respondents worked at academic centers. Thirty-seven (64%) practiced colorectal surgery, 24 (41%) endocrine surgery and 45 (78%) had experience in advanced minimally invasive surgery. An open, laparoscopic or robotic approach was preferred by 23 (42%), 24 (44%), and 8 (15%) respondents, respectively. Reasons to opt for a minimally invasive approach were mainly related to peri-operative benefits, while an open approach was preferred for optimal mesenteric lymphadenectomy and tactile feedback. Additional training in minimally invasive SB-NEN resection was welcomed by 29 (52%) respondents. Forty-three (74%) respondents were interested in collaborating in future studies, with a cumulative median (IQR) annual case load of 172 (86e258). Conclusions: Among respondents, 69% applies minimally invasive surgery for resection of SB-NEN. Arguments for specific operative approaches differ, and insufficient training in advanced laparoscopic techniques seems to be a barrier. Future collaborative studies can provide better insight in selection criteria and optimal technique.
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Available online 18 November 2021
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© 2021 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).