Abstract:
BACKGROUND:Different results and opinions exist concerning the use of a standard or an extended lymphadenectomy, and about the indications for portal vein resection in the surgical treatment of pancreatic cancer. The site of recurrence of pancreatic cancer may help to define the usefulness of different treatments in avoiding local and/or distant recurrences. METHODS:From personal experience and a literature review, 841 patients who underwent portal vein resection were collected, and 29 papers reporting the results of extended lymphadenectomy in the surgical treatment of pancreatic cancer were analyzed. A review of the site of relapse according to the surgical treatment, with or without various adjuvant treatments, was performed. Personal experience on survival rate according to the site of relapse (local, distant, local and distant) is also reported. RESULTS:Portal vein resection has been performed without a significant increase in morbidity and mortality rate in a large number of patients. However, its usefulness for increasing the resectability rate and the long-term survival has yet to be established. Extended lymphadenectomy does not increase the morbidity and mortality rate, but conflicting results on long-term survival have been reported. Distant metastases, undetectable by the radiologist and the surgeon, usually kill more than 40% of the resected patients within 12 months. Only lymph node-positive patients with limited undetectable distant metastases seem to benefit from an extended lymphadenectomy. Although many data are lacking, the incidence of the different sites of relapse is the same whatever the surgical and/or adjuvant treatment performed. Overall survival and disease-free survival rate are not affected by the site of relapse. A significantly worse survival rate was observed after the radiological detection of local and distant metastasis than after an only local or only distant metastasis. CONCLUSION:Portal vein resection and extended lymphadenectomy can be performed without increasing the surgical morbidity and mortality rate. We still have insufficient data to decide which patient can benefit from a more extended procedure. Standardization of operations, terminology, pathological reporting, and follow-up, together with well-designed prospective studies, will help to decide the operation of choice for pancreatic cancer.
journal_name
Dig Surgjournal_title
Digestive surgeryauthors
Pedrazzoli S,Pasquali C,Sperti Cdoi
10.1159/000018735subject
Has Abstractpub_date
1999-01-01 00:00:00pages
265-75issue
4eissn
0253-4886issn
1421-9883pii
18735journal_volume
16pub_type
杂志文章,评审abstract::Several methods for assessment of methodological quality in randomized controlled trials (RCTs) have been developed during the past few years. Factors associated with quality in laparoscopic surgery have not been defined till date. The aim of this study was to investigate the relationship between bibliometric and the ...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000381886
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Pancreatic serous cystic tumors are considered to have a benign biological and clinical course with only few malignant cases. METHODS:We retrospectively analyzed data from 26 patients affected by serous cystic tumors consecutively observed in our Pancreas Unit. We explored the different clinical pictures in...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000142947
更新日期:2008-01-01 00:00:00
abstract:INTRODUCTION:Ehlers-Danlos syndrome (EDS) is a rare inherited group of connective tissue diseases characterized by joint hypermobility, skin hyperextensibility and bruising tendency. Common features of patients with EDS include vascular and gastrointestinal perforations. The purpose of this systematic review is to addr...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000343738
更新日期:2012-01-01 00:00:00
abstract::Tumour recurrence that obstructs the afferent limb, blocking outflow of bile and pancreatic juice, constitutes a major clinical problem after a Whipple procedure. The endoscopic route is often not a possible alternative. Surgery may be difficult and perhaps dangerous to the often very sick patient and decompression wi...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000071760
更新日期:2003-01-01 00:00:00
abstract:AIMS:To compare the diagnostic value of endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) in the differentiation of malignant from benign masses in the pancreatic head. METHODS:Within 14 months 95 prospective patients with masses in the pancreatic head were assigned for preoperative...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000051942
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:Laparoscopic distal pancreatectomy (LDP) for large pancreatic tumors may require prolonged dissection, and this could be associated with increased operative time and intraoperative complications. METHODS:From a total cohort of 190 consecutive patients undergoing LDP, 18 patients were found to have pancreati...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000445008
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Despite decennia of experience, ileal pouch anal anastomosis for ulcerative colitis is still associated with high complication rates. The development of automatic vessel sealers has resulted in the revival of a promising surgical alternative to the conventional procedure: close rectal dissection. By preservi...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000331255
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND/AIMS:Strictureplasty (SP) or miniresective 'bowel-sparing' techniques (MR) can prevent the risk of intestinal stomia and short bowel syndrome in patients affected by Crohn's disease (CD). The aim of this study was to analyze the perioperative morbidity and mortality in 104 of 138 consecutive patients treated...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000018845
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND/AIM:Laparoscopy-assisted surgery has proved useful in the treatment of early gastric cancer, but its use in advanced cancer has rarely been studied. To investigate the efficacy and advantages of laparoscopy-assisted distal gastrectomy (LADG) with D2 dissection of lymph nodes versus conventional open D2 dista...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000281818
更新日期:2010-01-01 00:00:00
abstract::The symptoms of necrolytic migratory erythema, diabetes, stomatitis, weight loss and diarrhoea represent the glucagonoma syndrome which has been recognized since the early 1970s. Because of its rarity (1 case/20-200 million population) late diagnosis is frequent which leads to a poor prognosis. The case described, ori...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000018696
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND:Diverticulitis can lead to localized or generalized peritonitis and consequently induce abdominal adhesion formation. If adhesions would lead to abdominal complaints, it might be expected that these would be more prominent after operation for perforated diverticulitis with peritonitis than after elective sig...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000486868
更新日期:2019-01-01 00:00:00
abstract:BACKGROUNDS:Endoscopic submucosal dissection (ESD) has been widely performed in the treatment of early esophageal squamous cell carcinoma (ESCC). Few studies have compared the long-term outcomes of esophageal ESD based on absolute indications and relative indications. The aim of the current study was to investigate the...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000507437
更新日期:2021-01-01 00:00:00
abstract::The surgical management of gastroesophageal reflux disease has been simplified by the availability of minimally invasive techniques to treat this condition. The indications and selection of patients remain the same as for open surgery and initial results with laparoscopic antireflux surgery show long-term results equa...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000018686
更新日期:1999-01-01 00:00:00
abstract:INTRODUCTION:In the management of pancreatic cystic neoplasms (PCN), size plays a crucial role as the expression of disease progression. While many evidences regarding the natural history of growing pancreatic cysts exist, almost no data are available regarding cysts with a reduction in size. METHODS:Radiological and ...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000485199
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND/AIMS:Because the TNM system disregards the number of lymph nodes dissected and inter-individual differences exist in the number of regional lymph nodes, the lymph node ratio (LNR), which is estimated by dividing the number of metastatic lymph nodes by the number of dissected lymph nodes, has been proposed as...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000355444
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Recently, detections of early gastric cancer (EGC) have been increasing, and the treatment strategies for gastric cancer have been changing. To demonstrate recent clinical experience of EGC in Japan and to assess modern strategies for the treatment of EGC, we investigated the English-language literature of t...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000065829
更新日期:2002-01-01 00:00:00
abstract:INTRODUCTION:The aim of this review is to summarize the available evidence for changes in bile composition following liver surgery and assess their use in predicting post-operative complications. MATERIALS AND METHODS:A literature search was undertaken for all studies focusing on bile composition, bile volume and anal...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000320459
更新日期:2010-01-01 00:00:00
abstract::As well as the pronounced effect on body mass index (BMI), bariatric surgery is increasingly recognized as being associated with improvements in morbidity and mortality in a range of conditions, from airways disease to cancer. In metabolic disease, the impact of bariatric surgery is particularly obvious with marked im...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000351440
更新日期:2014-01-01 00:00:00
abstract::One of the possible long-term complications following an ileoanal pouch procedure is the development of malignancy in the mucosa of the rectal stump. Only 10 such cases have been reported so far. We report the case of a 23-year-old male who had ulcerative colitis with high-grade dysplasia and underwent an ileoanal pou...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000068855
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:Despite the increasing number of reports on the favorable outcomes of laparoscopic surgery for gallbladder cancer (GBC), there is no consensus regarding this surgical procedure. OBJECTIVE:The study aimed to develop a consensus statement on the application of laparoscopic surgery for GBC based on expert opin...
journal_title:Digestive surgery
pub_type: 共识发展会议,杂志文章
doi:10.1159/000486207
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Therapeutic strategies to prevent port site recurrences in laparoscopy surgery of malignancies have not been investigated until now. METHODS:The effects of taurolidine, heparin, and povidone iodine on the growth of rat and human colon adenocarcinoma as well as gallbladder carcinoma were investigated in vitr...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000018754
更新日期:1999-01-01 00:00:00
abstract::Laparoscopic gastrectomy for gastric cancer is rapidly becoming popular because of the technical developments and the accumulated data of laparoscopic surgery in gastric cancer patients. The aim of this review is to present the current body of evidence and to highlight controversial issues of laparoscopic gastrectomy ...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000350884
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Early postoperative small bowel obstruction (EPSBO) is a common complication following colon cancer surgery. EPSBO is associated with increased hospital stays, mortality rates, and healthcare costs. The purpose of this study was to identify risk factors for EPSBO following elective colon cancer surgery. STU...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000468155
更新日期:2018-01-01 00:00:00
abstract::Hepatocellular adenomas (HCA) are rare benign tumours occurring mainly in women under oral contraceptives. HCA bleed frequently and transform rarely into hepatocellular carcinoma. Identification of genes recurrently mutated in HCA and good genotype/phenotype correlations provided the basis of a pathomolecular classifi...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000268406
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:A choice of retrosternal or orthotopic route for reconstruction exists after three-phase esophagectomy with cervical anastomosis. Whether the route of reconstruction affects postoperative morbidity, mortality and recurrence patterns remains controversial. STUDY DESIGN:Patients with cancer of the thoracic es...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000070387
更新日期:2003-01-01 00:00:00
abstract::With the advent of novel and somewhat effective chemotherapy against pancreas cancer, several groups developed a new interest on locally advanced pancreatic cancer (LAPC). Unresectable tumors constitute up to 80% of pancreatic cancer (PC) at the time of diagnosis and are associated with a 5-year overall survival of le...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000445021
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND/AIMS:To evaluate the short-term surgical outcomes of laparoscopic intersphincteric resection (ISR) for lower rectal cancer, and to compare them with a case-control series of open ISR. METHODS:Between July 2002 and March 2011, 29 patients with lower rectal cancer underwent laparoscopic ISR, and 22 of 29 pati...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000332007
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:The repair of bile duct strictures (BDS) requires identification of healthy bile duct proximal to the stenosis. Identification may be difficult in complex bile duct injuries after cholecystectomy or partial liver resection. AIM:We describe a technique to identify the prestenotic bile duct using the sentinel...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000227276
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:The optimal treatment of common bile duct (CBD) stones is controversial, and depends on local expertise, the patient's medical condition and the time of diagnosis. Current practice entails a wide variation in the duration of leaving T tubes in place, anywhere from 7 to 30 days, and in the time to postoperati...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000018612
更新日期:1998-01-01 00:00:00
abstract::One of the main reasons for the dismal prognosis of pancreatic ductal adenocarcinoma (PDAC) is its late diagnosis. At the time of presentation, only approximately 15-20% of all patients with PDAC are considered resectable and around 30% are considered borderline resectable. A surgical approach, which is the only curat...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000493466
更新日期:2019-01-01 00:00:00