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 curative option, is limited in borderline resectable patients by local involvement of surrounding structures. In borderline resectable pancreatic cancer (BRPC), neoadjuvant treatment regimens have been introduced with the rationale to downstage and downsize the tumor in order to enable resection and eliminate -microscopic distant metastases. However, there are no official guidelines for the preoperative treatment of BRPC. In the majority of cases, patients are administered -Gemcitabine-based or FOLFIRINOX-based chemotherapy regimens with or without radiation. Radiologic restaging after neoadjuvant therapy has to be judged with caution when it comes to predict tumor response and resectability, since inflammation induced by neoadjuvant therapy may mimic solid tumor. Patients who do not show any disease progression during neoadjuvant therapy should be offered surgical exploration, since a high percentage is likely to undergo resection with negative margins (R0) and, thus, achieve improved overall survival although imaging judged it unlikely. Despite the promising new approaches of neoadjuvant treatment regimens during the last 2 decades, surgery remains the first choice if the tumor appears to be primary resectable at the time of diagnosis. At present, there are no international guidelines regarding the preoperative treatment of BRPC. Therefore, in order to standardize and adjust neoadjuvant treatment in the future, new guidelines have to be determined on the basis of upcoming prospective randomized studies.
journal_name
Dig Surgjournal_title
Digestive surgeryauthors
Kaufmann B,Hartmann D,D'Haese JG,Stupakov P,Radenkovic D,Gloor B,Friess Hdoi
10.1159/000493466subject
Has Abstractpub_date
2019-01-01 00:00:00pages
455-461issue
6eissn
0253-4886issn
1421-9883pii
000493466journal_volume
36pub_type
杂志文章,评审abstract:BACKGROUND:Cholecystolithiasis is a common disease. Cholecystectomy is the main treatment method but is associated with various complications in some patients. This study explores a novel, minimally invasive surgery for the removal of calculi and the preservation of the gallbladder using a laparoscope combined with the...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000357823
更新日期:2013-01-01 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::We describe a case of splenic abscess following lithotripsy of pancreatic stones, for which emergency splenectomy eventually had to be performed. It is important to be aware of this complication, because splenic abscess is still a life-threatening entity. ...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000050140
更新日期:2001-01-01 00:00:00
abstract::A 26-year-old male was admitted to our hospital with a complaint of mild dysphagia. Preoperative examinations revealed a cystic lesion at the lower esophagus, thought to be a bronchogenic cyst. The patient underwent successful thoracoscopic tumor extirpation, assisted by endoscopy, without undergoing major thoracotomy...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000094751
更新日期:2006-01-01 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:Chyle leaks are a rare complication following abdominal surgery. The aim of this study is to describe the management of chyle leaks following surgery for pancreatico-duodenal malignancy. METHODS:Data were collated from a consecutive series of 105 patients who had undergone a pancreatico-duodenectomy for mal...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000108324
更新日期:2007-01-01 00:00:00
abstract:INTRODUCTION:Little data is available on the prognosis of esophageal cancer (EC) in Iran. We studied the short- and long-term survival of EC patients treated at the Cancer Institute of Iran. METHODS:619 patients were followed who had been operated in the years 1997-2006. The 1-month to 5-year survival rates of EC and ...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000354854
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND/AIMS:The surgical treatment of duodenogastric reflux (DGR), resistant to medical therapy, in patients with intact stomach is difficult to standardize. The aim of this study is to present our experience on 5 patients, all cholecystectomized, with severe DGR disease treated surgically. METHODS:Out of a group ...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000018583
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:Differentiating hepatic mucinous cystic neoplasms (MCNs) from simple hepatic cysts (SCs) preoperatively is a challenging task. Our aim was to determine whether radiological features on ultrasound scan (USS), CT or MRI, cyst fluid tumour markers, or multidisciplinary team (MDT) outcomes could differentiate MC...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000447308
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Although evidence is growing that most patients who need an operation for diverticular disease of the sigmoid colon can be treated by a single-stage procedure, a two-stage procedure will still be necessary in some patients because of significant sepsis or technical difficulties. The outcomes of 65 patients w...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000091444
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND/AIMS:Approximately 20% of patients undergoing surgery for ulcerative colitis will retain their rectum. A single-stage proctocolectomy could be an appropriate procedure in patients who are definitely not candidates for a later restorative procedure, but it is generally not advised in acutely ill patients. The...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000381033
更新日期:2015-01-01 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:AIMS:To describe the extremely rare case of an adenomyoma of the papilla of Vater. CASE REPORT:A 42-year-old woman was hospitalized for epigastralgia and high fever. The clinical presentation and endoscopic, biochemical, and radiologic findings led to the diagnostic impression of a dysfunction of the papilla of Vater....
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000050115
更新日期:2001-01-01 00:00:00
abstract:AIMS:To evaluate the role of the Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM), the Portsmouth variant (p-POSSUM) and the Glasgow Prognostic Score (GPS) in predicting outcome after pancreatic surgery with reference to the International Study Group of Pancreatic Surge...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000313693
更新日期:2010-01-01 00:00:00
abstract::Infectious complications in surgical patients often originate from the intestinal microflora. In the critically ill patient, small bowel motility is disturbed, leading to bacterial overgrowth and subsequent bacterial translocation due to dysfunction of the gut mucosal barrier. The optimal prophylactic strategy should ...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000088053
更新日期:2005-01-01 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/AIMS:Predicting models of operative morbidity and mortality in the geriatric population are important in the prevention of adverse surgical outcomes. METHODS:A retrospective review of medical records was performed for patients over 80 years of age who underwent gastrointestinal surgery from 1998 to 2008. R...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000274485
更新日期:2010-08-01 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::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:OBJECTIVE:Systemic and/or local interleukin-6 (IL-6) reportedly plays an active role in the progression and prognosis of thoracic esophageal squamous cell carcinoma (TESCC). We assessed the associations between IL-6 and IL-6 receptor (IL-6R) genetic polymorphisms, tumoral IL-6 expression and survival rates following su...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000336952
更新日期:2012-01-01 00:00:00
abstract::Anastomotic leakage after colorectal surgery is correlated with considerable morbidity and mortality. Although many studies focus on risk factors and detection, studies on the treatment strategy for colorectal anastomotic leakage are scarce. A national questionnaire amongst 350 members of the Dutch Society for Gastroi...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000346348
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Perianal warts are common, and may be extensive. Electrocoagulation is a recognised management option. METHOD:A 20-year-old male underwent electrocautery of extensive perianal warts. He presented 3 months postoperatively with constipation and inability to defecate. Examination revealed severe perianal stric...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000018856
更新日期:2000-01-01 00:00:00
abstract::Ectopic pancreas is an uncommon condition and is usually found in the gastrointestinal tract, such as stomach, duodenum and jejunum. However, ectopic pancreas in the ampulla of Vater is rare and its clinical presentations may be similar to periampullary cancer. It is difficult to diagnose preoperatively. We present su...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000096158
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:Mechanical stapling devices are widely used in all fields of surgery as they can cut and sew tissue in a quick and easy manner. However, complications like bleeding or leakage at the staple line are frequently encountered and can have devastating consequences. Recent developments have led to the introduction...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000096648
更新日期:2006-01-01 00:00:00
abstract::Despite the fact that laparoscopic hernia repair was already described in 1979, its value has still not been well defined. The standard treatment for uncomplicated primary hernia repair in Europe is an open anterior approach (i.e. Shouldice), and 'tension-free' mesh plug repair in the USA. At present, posterior mesh i...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000018611
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:It is unclear whether total gastrectomy (TG) is always necessary for gastric cancer of the cardia. We therefore investigated whether cardiac cancers treated by TG would have been cured by proximal gastrectomy (PG). METHODS:Photocopies of the resected stomachs of 55 patients who had received TG for cardiac c...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000052000
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:Management of leakages of the gastrojejunal anastomosis after laparoscopic Roux-en-Y gastric bypass (LRYGB) can be complex. New endoscopic techniques such as covered stents and over-the-scope clips (OTCs) have been developed and are valuable alternative therapeutic options to reoperation and drainage. The ai...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000358849
更新日期:2014-01-01 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: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:BACKGROUND/AIMS:Oesophageal intubation remains one of the principal methods of palliation for an obstructing oesophageal carcinoma. We present a case which illustrates a rare but fatal complication of this procedure. METHODS:A 60-year-old female with oesophageal cancer presented with total dysphagia 9 months following...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000018886
更新日期:2000-01-01 00:00:00