Small pancreatic neuroendocrine tumors: Resect or enucleate?

Abstract:

BACKGROUND:The aim of this analysis is to compare the postoperative outcomes of resection and enucleation of small pancreatic neuroendocrine tumors (PNETs). METHODS:The 2014-17 American College of Surgeons-NSQIP dataset was queried. Patients undergoing pancreatoduodenectomy (N = 297) or distal pancreatectomy (N = 712) for nonfunctional, small PNETs (T1/T2) were compared to 127 patients (11%) who were enucleated. RESULTS:Operative time (170 vs 261, p < 0.01) and transfusions were less in the enucleation cohort (1.6% vs 6.7% p < 0.01). There was no difference in postoperative pancreatic fistulas, but morbidity was lower in enucleated patients (36.2% vs 48.7% p < 0.01). Fifteen resected patients died postoperatively (1.5%) while all enucleated patients survived (p = 0.058). Mean postoperative length of stay was shorter after enucleation (5.7 vs 7.2 days p < 0.01). CONCLUSIONS:Enucleation of PNETs is performed in only 11% of patients, but takes less time, requires fewer transfusions, and is associated with reduced morbidity and shorter length of stay than resection.

journal_name

Am J Surg

authors

Beane JD,Borrebach JD,Billderback A,Onuma AE,Adam MA,Zureikat AH,Pitt HA

doi

10.1016/j.amjsurg.2020.12.013

subject

Has Abstract

pub_date

2020-12-08 00:00:00

eissn

0002-9610

issn

1879-1883

pii

S0002-9610(20)30791-1

pub_type

杂志文章
  • Baseline circulating ghrelin does not predict weight regain neither maintenance of weight loss after gastric bypass at long term.

    abstract:BACKGROUND:Predictors of weight loss (WL) or weight regain (WR) after Roux-en-Y gastric bypass (RYGBP) are not established. The aim of this study was to analyze the usefulness of some baseline peptides (leptin, insulin, and ghrelin) as biomarkers of WL and WR in morbid obese patients after RYGBP at long term. METHODS:...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/j.amjsurg.2014.08.040

    authors: Pellitero S,Pérez-Romero N,Martínez E,Granada ML,Moreno P,Balibrea JM,Tarascó J,Lucas A,Puig-Domingo M

    更新日期:2015-08-01 00:00:00

  • Conservative treatment of vascular prosthetic graft infection is associated with high mortality.

    abstract:BACKGROUND:The aim of this study was to identify patient-related and/or disease-related factors that influence outcomes in patients with vascular prosthetic graft infections. METHODS:Through the hospital patient administration system, between January 1997 and December 2007, a total of 44 patients were diagnosed with c...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/j.amjsurg.2009.05.018

    authors: Saleem BR,Meerwaldt R,Tielliu IF,Verhoeven EL,van den Dungen JJ,Zeebregts CJ

    更新日期:2010-07-01 00:00:00

  • Partial laryngectomy: analysis of associated swallowing disorders.

    abstract::Evaluation of postoperative swallowing ability in thirty-eight patients having had partial laryngectomy indicates that there are marked differences in the degree of dysphagia among individuals with similar surgical defects. This variation in swallowing disability, however, appears to have definable limits. Rehabilitat...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/0002-9610(78)90266-0

    authors: Weaver AW,Fleming SM

    更新日期:1978-10-01 00:00:00

  • Possible mechanism of the synergistic effect of heparin and dihydroergotamine.

    abstract::A combination of heparin and dihydroergotamine mesylate (Heparin-Dihydergot) has been shown to be more effective than either of these drugs alone in preventing postoperative venous thromboembolism. The possible mechanism for the synergistic effect of heparin and dihydroergotamine was assessed. Phlebograms obtained aft...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:

    authors: Kakkar VV,Welzel D,Murray WJ,Malone P,Jones D

    更新日期:1985-10-08 00:00:00

  • Nitric oxide: an overview.

    abstract::Nitric oxide (NO), a paracrine-acting gas enzymatically synthesized from L-arginine, is a unique biologic mediator that has been implicated in a myriad of physiologic and pathophysiologic states. It is an important regulator of vascular tone and may be the mediator of the hemodynamic changes involved in sepsis and cir...

    journal_title:American journal of surgery

    pub_type: 杂志文章,评审

    doi:10.1016/s0002-9610(05)80017-0

    authors: Rodeberg DA,Chaet MS,Bass RC,Arkovitz MS,Garcia VF

    更新日期:1995-09-01 00:00:00

  • Reduction of ischemia/reperfusion injury by antithrombin III after experimental pancreas transplantation.

    abstract:BACKGROUND:Graft pancreatitis is a major complication after pancreas transplantation. Antithrombin III (AT III) is an anticoagulatory and anti-inflammatory substance. The aim of our study was to evaluate a prophylactic application of AT III in experimental pancreas transplantation. METHODS:Pancreas transplantation was...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/j.amjsurg.2004.03.017

    authors: Hackert T,Werner J,Uhl W,Gebhard MM,Büchler MW,Schmidt J

    更新日期:2005-01-01 00:00:00

  • Effects of a static magnetic field on wound healing: results in experimental rat colon anastomoses.

    abstract:BACKGROUND:Research has shown that pulsed electromagnetic fields (EMFs) promote wound healing in experimental colonic anastomosis; however, the effects of static EMFs in this setting have not been investigated to date. METHODS:Fifty male Wistar rats were used. Ten served as controls for mechanical strength testing, an...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/j.amjsurg.2006.01.024

    authors: Nursal TZ,Bal N,Anarat R,Colakoglu T,Noyan T,Moray G,Haberal M

    更新日期:2006-07-01 00:00:00

  • Hepatic resection for large hepatocellular carcinoma.

    abstract:BACKGROUND:Long-term survival and prognostic factors after hepatic resection for large hepatocellular carcinoma (HCC) remain to be proved. METHODS:The surgical outcome in 133 consecutive patients with HCC in diameter of > or = 5 cm (large HCC; L group) undergoing hepatic resection was retrospectively clarified and com...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/s0002-9610(01)00584-0

    authors: Hanazaki K,Kajikawa S,Shimozawa N,Shimada K,Hiraguri M,Koide N,Adachi W,Amano J

    更新日期:2001-04-01 00:00:00

  • Getting to the bottom of treatment of rectal prolapse in the elderly: Analysis of the National Surgical Quality Improvement Program (NSQIP).

    abstract:BACKGROUND:Many approaches to treat rectal prolapse exists, yet little is known regarding their safety in the elderly. METHOD:NSQIP (2008-2014) was queried to identify patients ≥ 70 years who underwent open rectopexy (OR), laparoscopic rectopexy (LR) and perineal rectosigmoidectomy (PR). Patients were selected using N...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/j.amjsurg.2019.02.010

    authors: Daniel VT,Davids JS,Sturrock PR,Maykel JA,Phatak UR,Alavi K

    更新日期:2019-08-01 00:00:00

  • Improved cannula for operative (cystic duct) cholangiography.

    abstract::A new S-shaped cystic duct metal cannula was developed and used successfully in 200 cystic duct cholangiograms. It has the advantage of being easy to manipulate because the configuration does not obscure the vision and the resistance is less than that of plastic tubes, facilitating injection with lower pressure. It is...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/0002-9610(79)90106-5

    authors: Berci G,Shore JM

    更新日期:1979-06-01 00:00:00

  • Streptococcus milleri infections of the pleural space: operative management predominates.

    abstract:BACKGROUND:Management of patients with thoracic empyema ranges from tube thoracostomy drainage, with or without fibrinolytics, to operative intervention, with the optimal intervention remaining uncertain. Streptococcus milleri, typically a benign bacterium colonizing the oropharynx, has recently been reported as a pote...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/j.amjsurg.2006.08.050

    authors: Ripley RT,Cothren CC,Moore EE,Long J,Johnson JL,Haenel JB

    更新日期:2006-12-01 00:00:00

  • The association of neurofibromatosis and hyperparathyroidism.

    abstract::Two patients with coexisting neurofibromatosis and hyperparathyroidism are described, bringing the total number of such cases in the world literature to seven. Other more classic examples of the association of tumorous conditions of neuroectodermal and entodermal origin are discussed to support the suggestion that the...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/0002-9610(79)90079-5

    authors: Chakrabarti S,Murugesan A,Arida EJ

    更新日期:1979-03-01 00:00:00

  • Management of adverse surgical events: a structured education module for residents.

    abstract:BACKGROUND:This pilot project involved the development of a structured, experiential, educational module using a bench model technical skills simulation and standardized patients. It integrated teaching and assessment of clinical, technical, and interpersonal skills, as well as professionalism within the context of an ...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/j.amjsurg.2005.07.003

    authors: Brewster LP,Risucci DA,Joehl RJ,Littooy FN,Temeck BK,Blair PG,Sachdeva AK

    更新日期:2005-11-01 00:00:00

  • Does increased experience with laparoscopic cholecystectomy yield more complex bile duct injuries?

    abstract:BACKGROUND:Two decades since the advent of laparoscopic cholecystectomy, the rate of bile duct injuries still remains higher than in the open cholecystectomy era. METHODS:The rate and complexity of bile duct injuries was evaluated in 83,449 patients who underwent laparoscopic cholecystectomy between 1995 and 2008 in t...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/j.amjsurg.2011.08.018

    authors: Chuang KI,Corley D,Postlethwaite DA,Merchant M,Harris HW

    更新日期:2012-04-01 00:00:00

  • Routine preoperative lymphoscintigraphy is not necessary prior to sentinel node biopsy for breast cancer.

    abstract:BACKGROUND:This prospective study was performed to ascertain the added benefit of lymphoscintigraphy to a standard method of intraoperative lymphatic mapping and sentinel node biopsy for breast cancer. METHODS:Patients with invasive breast cancer were injected with 99mTc sulfur colloid prior to sentinel node biopsy; p...

    journal_title:American journal of surgery

    pub_type: 临床试验,杂志文章

    doi:10.1016/s0002-9610(99)00088-4

    authors: Burak WE Jr,Walker MJ,Yee LD,Kim JA,Saha S,Hinkle G,Olsen JO,Pozderac R,Farrar WB

    更新日期:1999-06-01 00:00:00

  • Partial stomach-partitioning gastrojejunostomy and the success of this procedure in terms of palliation.

    abstract:BACKGROUND:In the 1990s, partial stomach-partitioning gastrojejunostomy (PSPG) was introduced. Benefits of this method are that it preferentially shunts food away from the obstructed duodenum or pylorus, thus reducing reflex emesis. METHODS:A retrospective review of patients undergoing PSPG for malignant obstruction f...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/j.amjsurg.2012.11.015

    authors: Arrangoiz R,Papavasiliou P,Singla S,Siripurapu V,Li T,Watson JC,Hoffman JP,Farma JM

    更新日期:2013-09-01 00:00:00

  • The hypertensive lower esophageal sphincter.

    abstract:BACKGROUND:This study defines the entity of the hypertensive lower esophageal sphincter (HLES) and its treatment, including surgical implications. METHODS:Esophageal manometry was performed on 1,300 patients. Of these, 53 (4%) had HLES with resting pressure > 26.5 mm Hg, defined as the upper limit of normal resting LE...

    journal_title:American journal of surgery

    pub_type: 临床试验,杂志文章

    doi:10.1016/S0002-9610(96)00219-X

    authors: Katada N,Hinder RA,Hinder PR,Lund RJ,Perdikis G,Stalzer RA,McGinn TR

    更新日期:1996-11-01 00:00:00

  • Survival after surgery for advanced carcinoma of the stomach other than the cardia.

    abstract::The survival of 103 patients operated on for advanced carcinoma of the stomach other than the cardia was assessed. The median duration of survival for patients subjected to palliative partial gastrectomy, total gastrectomy, gastrojejunostomy, and biopsy only was 24, 22, 11, and 10 weeks, respectively. All of these pat...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/0002-9610(82)90051-4

    authors: Choi TK,Koo J,Wong J,Ong GB

    更新日期:1982-06-01 00:00:00

  • Relationship between pancreatic and serum amylase in basal conditions and during stimulation in man. Report of a new intraoperative technique.

    abstract::The correlation between serum amylase and pancreatic amylase secretion was studied in two patients. Both patients underwent sphincterotomy, and the pancreatic duct was cannulated with a polyethylene tube. The tube was left in place for 15 to 21 days. The rate of amylase secretion over 7 days was studied in response to...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/0002-9610(82)90178-7

    authors: Lezoche E,Carlei F,Vagni V,Rossini S,De Masi E,Passaro E Jr,Speranza V

    更新日期:1982-05-01 00:00:00

  • Technique for inguinal hernia repair in the elderly patient.

    abstract::A technique for the repair of inguinal hernias in elderly patients with weak abdominal muscles has been presented. It consists of the overlapping of the flaps of the aponeurosis of the external oblique muscle according to the method previously proposed by Andrews. To date, the technique has given good results, even in...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/0002-9610(83)90419-1

    authors: Nano M

    更新日期:1983-09-01 00:00:00

  • Effects of early use of external pelvic compression on transfusion requirements and mortality in pelvic fractures.

    abstract:BACKGROUND:We hypothesized that early use of external mechanical compression (EMC) reduces hemorrhage and mortality associated with pelvic fractures. METHODS:Patients with pelvic fractures and one of the following risk factors for hemorrhage were studied retrospectively: (1) unstable fracture pattern, or (2) any fract...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/j.amjsurg.2007.08.040

    authors: Ghaemmaghami V,Sperry J,Gunst M,Friese R,Starr A,Frankel H,Gentilello LM,Shafi S

    更新日期:2007-12-01 00:00:00

  • A meta-analysis of the efficacy of prophylactic alpha-blockade for the prevention of urinary retention following primary unilateral inguinal hernia repair.

    abstract:BACKGROUND:Urinary retention following inguinal hernia surgery is common and is believed to be associated with adrenergic over-stimulation of the smooth muscle in the bladder neck and prostate. The efficacy of prophylactic alpha-blockade in the prevention of urinary retention following elective inguinal hernia repair i...

    journal_title:American journal of surgery

    pub_type: 杂志文章,meta分析,评审

    doi:10.1016/j.amjsurg.2017.02.017

    authors: Clancy C,Coffey JC,O'Riordain MG,Burke JP

    更新日期:2018-08-01 00:00:00

  • Effect of metatarsal head resection for diabetic foot ulcers on the dynamic plantar pressure distribution.

    abstract::Diabetic neuropathic ulcers are thought to arise from repetitive injury during normal walking in areas of high plantar pressures. It has been suggested that metatarsal head (MTH) resection alleviates elevated pressures at the site of the ulcer and, thus, expedites healing and prevents recurrence. We investigated the e...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/0002-9610(94)90203-8

    authors: Patel VG,Wieman TJ

    更新日期:1994-03-01 00:00:00

  • Pancreatic incidentalomas: clinical and pathologic spectrum.

    abstract:BACKGROUND:Incidental abnormalities are increasingly being detected. The pathology and clinical outcome of patients with pancreatic incidentalomas have not been well characterized. METHODS:We reviewed the records of 356 patients with pancreatic abnormalities from August 2001 to June 2007. Clinical and pathologic data ...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/j.amjsurg.2007.12.027

    authors: Bruzoni M,Johnston E,Sasson AR

    更新日期:2008-03-01 00:00:00

  • Lymph node metastases in cancer of the thoracic esophagus.

    abstract::Curettage of lymph nodes in 36 patients with cancer of the thoracic esophagus was performed in the bilateral supraclavicular, right intrathoracic and abdominal regions. The overall metastatic ratio in lymph nodes was 52.8 percent (19 of 36). It was particularly high in the right supraclavicular nodes (26.7 percent), t...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/0002-9610(81)90160-4

    authors: Sannohe Y,Hiratsuka R,Doki K

    更新日期:1981-02-01 00:00:00

  • Options for elective treatment of portal hypertension in cirrhotic patients in the transplantation era.

    abstract::We review herein our experience in the management of bleeding esophageal varices in cirrhotic patients and consider our findings in light of the dramatic changes in the treatment of cirrhosis resulting from the more widespread use of orthotopic liver transplantation (OLT). It does not seem realistic, at present, to pr...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/s0002-9610(05)80878-5

    authors: Bismuth H,Adam R,Mathur S,Sherlock D

    更新日期:1990-07-01 00:00:00

  • Does implementing a general surgery residency program and resident involvement affect patient outcomes and increase care-associated charges?

    abstract:BACKGROUND:Variable results regarding general surgery residency program (GSRP) impact on patient outcomes and charges are reported. The aim of this study was to determine any significant differences in patient outcomes and cost with a new GSRP. METHODS:We analyzed all laparoscopic appendectomies (lap-ap), cholecystect...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/j.amjsurg.2016.11.016

    authors: Wexner T,Rosales-Velderrain A,Wexner SD,Rosenthal RJ

    更新日期:2017-07-01 00:00:00

  • Improved positioning of the upper arm graft fistula for hemodialysis.

    abstract::An improved technique is presented for placement of the upper arm graft fistula for hemodialysis. This approach brings the graft anteriorly across the front of the biceps muscle, thereby allowing easier puncture and greater comfort for the patient during dialysis treatment. ...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/0002-9610(86)90478-2

    authors: Gifford RM

    更新日期:1986-03-01 00:00:00

  • Preoperative selection of patients for lumbar sympathectomy by use of the Doppler index.

    abstract::Yao and Bergan [8] have shown that an ankle systolic index of more than 0.25 is associated with a high rate of success from lumbar sympathectomy. This association has been borne out in our small series. We have also suggested that diseases that obviously compromise collateral circulation might be a relative contraindi...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/0002-9610(77)90316-6

    authors: Seeger JM,Lazarus HM,Albo D Jr

    更新日期:1977-12-01 00:00:00

  • Prestorage leukoreduction abrogates the detrimental effect of aging on packed red cells transfused after trauma: a prospective cohort study.

    abstract:BACKGROUND:The aim of this study was to prospectively duplicate previous retrospective findings showing that prestorage leukoreduction blunts the detrimental effect of aging on banked packed red blood cells transfused after injury. METHODS:Over 19 months, trauma patients transfused with ≥4 U of packed red blood cells ...

    journal_title:American journal of surgery

    pub_type: 临床试验,杂志文章

    doi:10.1016/j.amjsurg.2011.05.012

    authors: Phelan HA,Eastman AL,Aldy K,Carroll EA,Nakonezny PA,Jan T,Howard JL,Chen Y,Friese RS,Minei JP

    更新日期:2012-02-01 00:00:00