Laparoscopic resection of small bowel neuroendocrine tumors: A long-term survival analysis

Small bowel neuroendocrine tumors (SBNET) are rare neoplasms that often present insidiously and may be associated with mesenteric fibrosis and advanced disease at diagnosis. While open surgery has traditionally been the standard of care, the role of laparoscopic resection in patients with complex SBNET remains under evaluation. We performed a retrospective analysis of all patients who underwent laparoscopic resection for SBNET at a tertiary referral center between 2002 and 2022. Clinical, operative, and oncologic data were extracted from a prospectively maintained database and reviewed for perioperative outcomes and long-term survival. Forty patients (mean age 62.2 years; 55% male) underwent laparoscopic resection, with a conversion rate of 7.5%. The ileum was the most common primary site (85%), and 75% of patients harbored a mesenteric mass. Postoperative morbidity was low (10%, all minor), with no perioperative mortality. The mean hospital stay was 7 days. Most tumors were low-grade (72.5% grade 1), yet 62.5% of patients presented with stage IV disease. With a mean follow-up of 7 years, overall survival reached 95 months, and progression-free survival 61 months. Age at surgery was the only independent predictor of outcome. Laparoscopic resection of SBNET is feasible and safe in selected patients, including those with advanced disease and mesenteric involvement, providing favorable long-term oncologic outcomes. These findings support the important role of minimally invasive surgery as part of the management of SBNET.