{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T15:13:04Z","timestamp":1784128384607,"version":"3.55.0"},"reference-count":18,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T00:00:00Z","timestamp":1765152000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:p>\n                    Solid pseudopapillary neoplasms (SPNs) of the pancreas primarily affect young women, placing the surgical decision for distal tumors at a clinical crossroads: the oncologic necessity of splenectomy vs the long-term immunologic benefit of spleen preservation. This study synthesizes the current evidence to guide clinical practice. We conducted a systematic review and meta-analysis comparing laparoscopic spleen-preserving distal pancreatectomy (LSPDP) with laparoscopic distal pancreatectomy with splenectomy (LSDP) for SPN, identifying 3 retrospective studies (n = 96 patients). The evidence base, though limited, showed comparable perioperative morbidity. No significant differences were found in overall complications (OR = 0.73; 95% CI: 0.23 to 2.31;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.60), postoperative pancreatic fistula (OR = 0.51; 95% CI: 0.09 to 2.92;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.45), or severe complications (OR = 0.32; 95% CI: 0.05 to 1.96;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.22). Laparoscopic distal pancreatectomy with splenectomy was associated with a significantly shorter operative time (MD = \u221263.49\u00a0min; 95% CI: \u2212123.79 to \u22123.18;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.04). A non-significant trend toward a higher lymph node yield was observed in the LSDP group (MD = +4.29; 95% CI: \u22120.29 to 8.86;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.07). The available evidence suggests LSPDP is a safe and feasible option in selected patients, achieving comparable short-term morbidity to LSDP. Given the low malignant potential of SPNs and the lifelong immunologic benefits of splenic function, especially in the typical young patient demographic, LSPDP should be the preferred approach when oncologically and technically feasible. This review provides a practical framework for surgical decision making in this rare tumor.\n                  <\/jats:p>","DOI":"10.1177\/00031348251405568","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T16:20:54Z","timestamp":1765210854000},"page":"1514-1520","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Spleen Preservation in Solid Pseudopapillary Neoplasms: Evidence, Rationale, and Practical Considerations"],"prefix":"10.1177","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-5598-2063","authenticated-orcid":false,"given":"M.C.","family":"Lenzi","sequence":"first","affiliation":[{"name":"Universidade Do Estado Do Rio Grande Do Norte (UERN)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.C.A.P.","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina de Petr\u00f3polis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.F.S","family":"Rocha","sequence":"additional","affiliation":[{"name":"Faculdade de Sa\u00fade e Ecologia Humana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.H.","family":"Juca","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Campinas (UNICAMP)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9256-4788","authenticated-orcid":false,"given":"M.","family":"De Oliveira Filho","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina de Barbacena"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2794-9959","authenticated-orcid":false,"given":"D.L.S.","family":"Souza","sequence":"additional","affiliation":[{"name":"TriHealth Good Samaritan Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6536-0862","authenticated-orcid":false,"given":"M.de M.","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Universidade Do Estado Do Rio Grande Do Norte (UERN)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0258-2138","authenticated-orcid":false,"given":"A.U.L.","family":"Santana","sequence":"additional","affiliation":[{"name":"University of Sao Paulo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.A.F.","family":"Camarotti","sequence":"additional","affiliation":[{"name":"University of Pernambuco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.M","family":"Portugal","sequence":"additional","affiliation":[{"name":"Ipiranga Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.B.","family":"De Mello","sequence":"additional","affiliation":[{"name":"Departament of General Surgery, Hospital Rede D\u2019Or"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,12,8]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2007.07.030"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/PAP.0b013e31815e5237"},{"key":"e_1_3_6_4_2","volume-title":"WHO Classification of Tumours of the Digestive System","author":"Bosman FT","year":"2010","unstructured":"Bosman FT, Carneiro F, Hruban RH, Theise ND, eds. WHO Classification of Tumours of the Digestive System. 4th ed. World Health Organization; 2010.","edition":"4"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000000583"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1089\/lap.2018.0704"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2005.02.011"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.137.2.164"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9366"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2014.11.005"},{"key":"e_1_3_6_11_2","article-title":"Spleen preservation versus splenectomy in laparoscopic distal pancreatectomy for solid pseudapillary neoplasms: a systematic review and meta-analysis on perioperative and oncological outcomes","author":"Lenzi MC","year":"2025","unstructured":"Lenzi MC, Carvalho MCAP, Rocha GFS, et al. Spleen preservation versus splenectomy in laparoscopic distal pancreatectomy for solid pseudapillary neoplasms: a systematic review and meta-analysis on perioperative and oncological outcomes. PROSPERO. 2025. https:\/\/www.crd.york.ac.uk\/prospero\/display_record.php?ID=CRD420251026718. Accessed 3 August 2025.","journal-title":"PROSPERO"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_3_6_13_2","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions","author":"Higgins JPT","year":"2022","unstructured":"Higgins JPT, Thomas J, Chandler J, et al., eds. Cochrane Handbook for Systematic Reviews of Interventions. Cochrane; 2022. https:\/\/www.training.cochrane.org\/handbook. Accessed 3 August 2025.Version 6.3."},{"key":"e_1_3_6_14_2","volume-title":"The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in meta-analyses","author":"Wells GA","unstructured":"Wells GA, Shea B, O'Connell D, et al. The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in meta-analyses. Ottawa Hospital Research Institute. https:\/\/www.ohri.ca\/programs\/clinical_epidemiology\/oxford.asp. 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