Local resection for solid pseudopapillary neoplasms of the pancreas shows improved postoperative gastrointestinal function and reduced mental stress: a multi-questionnaire survey from a large cohort.

BACKGROUND

Solid pseudopapillary neoplasm of the pancreas (SPN) is a rare, low-grade malignant pancreatic tumor with a highly favorable prognosis. Most SPN patients are young and middle-aged women. The main controversial topic for SPN is local resection (LR) versus radical resection (RR). Theoretically, local resection could lead to better gastrointestinal function (GIF) and less mental stress. However, no data is available to support this hypothesis.

METHODS

All SPN patients undergoing surgical treatment in XXXXXXXX Hospital from 2001 to 2021 were included in the study. A cross-sectional online multi-questionnaire survey containing 110 questions was sent to them (XXXXXXX). This online multi-questionnaire survey focused on GIF and mental stress and consisted of eight questionnaires. Multiple linear regression analysis was conducted to identify independent factors impacting GIF and mental stress.

RESULTS

A total of 183 cases provided valid results. Among them, 46 patients (25.1%) underwent LR, and 137 (74.9%) underwent RR. Ninety-four cases (51.4%) underwent minimally invasive surgery (MIS), while 89 (48.6%) underwent open surgery. The average GSRS score of the patients was 1.9±0.7, indicating that most suffered from mild gastrointestinal dysfunction. The scores of PHQ-9 and GAD-7 in 16 patients (8.7%) and 27 (14.8%) patients, respectively, were beyond 10.0, which indicated clinical depression and anxiety. Additionally, 19 (10.4%) patients reported poor ability to work, and 31(16.9%) patients had significant body image concerns. Compared to other clinicopathological characteristics, LR (LR vs. RR: PHQ-9 score, P=0.018; WAI average score, P=0.010; EORTC-QLQ C30, nine sub-domains, P<0.05; GSRS average score, P= 0.006) and MIS (MIS vs. open surgery: EORTC-QLQ C30, three sub-domains, P<0.05; GSRS average score, P=0.006) were the most significant factors predicting improved GIF and reduced mental stress.

CONCLUSIONS

This study systematically presents postoperative GIF and mental stress of SPN patients using validated multi-questionnaires for the first time. It provides solid evidence that LR and MIS can improve GIF and reduce mental stress after surgery for SPN patients, which could be helpful for the surgeons to make more personalized surgical plans for their patients.

Informations de copyright

Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.