Prognostic impact of conservative surgery for pancreatic IPMNs
Background: The extent of pancreatic resection for intraductal papillary mucinous neoplasms (IPMNs) remains an unresolved issue. The study aims at analyzing the prognostic impact of conservative surgery (CS) i.e. of pancreatoduodenectomy or distal pancreatectomy, versus total pancreatectomy (TP), fo...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Palmeri, Matteo [verfasserIn] Di Franco, Gregorio [verfasserIn] Bianchini, Matteo [verfasserIn] Guadagni, Simone [verfasserIn] Gianardi, Desirée [verfasserIn] Furbetta, Niccolò [verfasserIn] Caprili, Giovanni [verfasserIn] Fatucchi, Lorenzo Maria [verfasserIn] Sbrana, Andrea [verfasserIn] Funel, Niccola [verfasserIn] Pollina, Luca Emanuele [verfasserIn] Di Candio, Giulio [verfasserIn] Morelli, Luca [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2021 |
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| Schlagwörter: |
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| Übergeordnetes Werk: |
Enthalten in: Surgical oncology - Amsterdam [u.a.] : Elsevier Science, 1992, 38 |
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| Übergeordnetes Werk: |
volume:38 |
| DOI / URN: |
10.1016/j.suronc.2021.101582 |
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| Katalog-ID: |
ELV006548989 |
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| 520 | |a Background: The extent of pancreatic resection for intraductal papillary mucinous neoplasms (IPMNs) remains an unresolved issue. The study aims at analyzing the prognostic impact of conservative surgery (CS) i.e. of pancreatoduodenectomy or distal pancreatectomy, versus total pancreatectomy (TP), for pancreatic IPMNs.Methods: We retrospectively analyzed and compared data of patients who had undergone pancreatic resection for IPMNs at our center between November 2007 and April 2019. Patients were divided into two main groups based on the extent of surgery: TP-group and CS-group. Subsequently, the perioperative and the long-term outcomes were compared. Moreover, a sub-group analysis of patients with IPMN alone and patients with malignant IPMN, based on preoperative indications to surgery and post-operative histopathological findings, was also performed.Results: Fifty-three patients were included in the TP-group and 73 in the CS-group. In 50 (39.7%) cases the frozen section changed the pre-operative surgical planning, with an extension of the pancreatic resection, in 43 (34.1%) cases up to a total pancreatectomy. Twenty-six patients (20.6%) with low-grade dysplasia at the frozen section underwent CS, while twenty (15.8%) underwent TP. Comparing these two sub-groups no differences were found in surgical IPMN recurrence, nor progression. The rate of overall postoperative complications was 56.6% in the TP-group and 57.5% in the CS-group (p = 0.940). Fifteen patients (20.5%) developed diabetes in the CS-group.Conclusion: A timely CS can be considered an appropriate and valid strategy in the surgical treatment of the majority of pancreatic IPMNs, as it can avoid the serious long-term metabolic consequences of TP in patients with a long-life expectancy. On the contrary, TP remains mandatory in case of PDAC or high-risk features involving the entire gland. | ||
| 650 | 4 | |a IPMN | |
| 650 | 4 | |a Intraductal papillary mucinous neoplasms | |
| 650 | 4 | |a Pancreatic surgery | |
| 650 | 4 | |a Conservative surgery | |
| 650 | 4 | |a Surgical management | |
| 700 | 1 | |a Di Franco, Gregorio |e verfasserin |4 aut | |
| 700 | 1 | |a Bianchini, Matteo |e verfasserin |0 (orcid)0000-0002-2403-0621 |4 aut | |
| 700 | 1 | |a Guadagni, Simone |e verfasserin |4 aut | |
| 700 | 1 | |a Gianardi, Desirée |e verfasserin |4 aut | |
| 700 | 1 | |a Furbetta, Niccolò |e verfasserin |4 aut | |
| 700 | 1 | |a Caprili, Giovanni |e verfasserin |4 aut | |
| 700 | 1 | |a Fatucchi, Lorenzo Maria |e verfasserin |0 (orcid)0000-0001-6106-5519 |4 aut | |
| 700 | 1 | |a Sbrana, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Funel, Niccola |e verfasserin |4 aut | |
| 700 | 1 | |a Pollina, Luca Emanuele |e verfasserin |4 aut | |
| 700 | 1 | |a Di Candio, Giulio |e verfasserin |0 (orcid)0000-0003-2156-369X |4 aut | |
| 700 | 1 | |a Morelli, Luca |e verfasserin |4 aut | |
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10.1016/j.suronc.2021.101582 doi (DE-627)ELV006548989 (ELSEVIER)S0960-7404(21)00071-2 DE-627 ger DE-627 rda eng 610 DE-600 44.81 bkl 44.65 bkl Palmeri, Matteo verfasserin (orcid)0000-0002-9343-278X aut Prognostic impact of conservative surgery for pancreatic IPMNs 2021 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: The extent of pancreatic resection for intraductal papillary mucinous neoplasms (IPMNs) remains an unresolved issue. The study aims at analyzing the prognostic impact of conservative surgery (CS) i.e. of pancreatoduodenectomy or distal pancreatectomy, versus total pancreatectomy (TP), for pancreatic IPMNs.Methods: We retrospectively analyzed and compared data of patients who had undergone pancreatic resection for IPMNs at our center between November 2007 and April 2019. Patients were divided into two main groups based on the extent of surgery: TP-group and CS-group. Subsequently, the perioperative and the long-term outcomes were compared. Moreover, a sub-group analysis of patients with IPMN alone and patients with malignant IPMN, based on preoperative indications to surgery and post-operative histopathological findings, was also performed.Results: Fifty-three patients were included in the TP-group and 73 in the CS-group. In 50 (39.7%) cases the frozen section changed the pre-operative surgical planning, with an extension of the pancreatic resection, in 43 (34.1%) cases up to a total pancreatectomy. Twenty-six patients (20.6%) with low-grade dysplasia at the frozen section underwent CS, while twenty (15.8%) underwent TP. Comparing these two sub-groups no differences were found in surgical IPMN recurrence, nor progression. The rate of overall postoperative complications was 56.6% in the TP-group and 57.5% in the CS-group (p = 0.940). Fifteen patients (20.5%) developed diabetes in the CS-group.Conclusion: A timely CS can be considered an appropriate and valid strategy in the surgical treatment of the majority of pancreatic IPMNs, as it can avoid the serious long-term metabolic consequences of TP in patients with a long-life expectancy. On the contrary, TP remains mandatory in case of PDAC or high-risk features involving the entire gland. IPMN Intraductal papillary mucinous neoplasms Pancreatic surgery Conservative surgery Surgical management Di Franco, Gregorio verfasserin aut Bianchini, Matteo verfasserin (orcid)0000-0002-2403-0621 aut Guadagni, Simone verfasserin aut Gianardi, Desirée verfasserin aut Furbetta, Niccolò verfasserin aut Caprili, Giovanni verfasserin aut Fatucchi, Lorenzo Maria verfasserin (orcid)0000-0001-6106-5519 aut Sbrana, Andrea verfasserin aut Funel, Niccola verfasserin aut Pollina, Luca Emanuele verfasserin aut Di Candio, Giulio verfasserin (orcid)0000-0003-2156-369X aut Morelli, Luca verfasserin aut Enthalten in Surgical oncology Amsterdam [u.a.] : Elsevier Science, 1992 38 Online-Ressource (DE-627)32445290X (DE-600)2026613-3 (DE-576)098134388 1879-3320 nnns volume:38 GBV_USEFLAG_U SYSFLAG_U GBV_ELV GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.81 Onkologie 44.65 Chirurgie AR 38 |
| spelling |
10.1016/j.suronc.2021.101582 doi (DE-627)ELV006548989 (ELSEVIER)S0960-7404(21)00071-2 DE-627 ger DE-627 rda eng 610 DE-600 44.81 bkl 44.65 bkl Palmeri, Matteo verfasserin (orcid)0000-0002-9343-278X aut Prognostic impact of conservative surgery for pancreatic IPMNs 2021 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: The extent of pancreatic resection for intraductal papillary mucinous neoplasms (IPMNs) remains an unresolved issue. The study aims at analyzing the prognostic impact of conservative surgery (CS) i.e. of pancreatoduodenectomy or distal pancreatectomy, versus total pancreatectomy (TP), for pancreatic IPMNs.Methods: We retrospectively analyzed and compared data of patients who had undergone pancreatic resection for IPMNs at our center between November 2007 and April 2019. Patients were divided into two main groups based on the extent of surgery: TP-group and CS-group. Subsequently, the perioperative and the long-term outcomes were compared. Moreover, a sub-group analysis of patients with IPMN alone and patients with malignant IPMN, based on preoperative indications to surgery and post-operative histopathological findings, was also performed.Results: Fifty-three patients were included in the TP-group and 73 in the CS-group. In 50 (39.7%) cases the frozen section changed the pre-operative surgical planning, with an extension of the pancreatic resection, in 43 (34.1%) cases up to a total pancreatectomy. Twenty-six patients (20.6%) with low-grade dysplasia at the frozen section underwent CS, while twenty (15.8%) underwent TP. Comparing these two sub-groups no differences were found in surgical IPMN recurrence, nor progression. The rate of overall postoperative complications was 56.6% in the TP-group and 57.5% in the CS-group (p = 0.940). Fifteen patients (20.5%) developed diabetes in the CS-group.Conclusion: A timely CS can be considered an appropriate and valid strategy in the surgical treatment of the majority of pancreatic IPMNs, as it can avoid the serious long-term metabolic consequences of TP in patients with a long-life expectancy. On the contrary, TP remains mandatory in case of PDAC or high-risk features involving the entire gland. IPMN Intraductal papillary mucinous neoplasms Pancreatic surgery Conservative surgery Surgical management Di Franco, Gregorio verfasserin aut Bianchini, Matteo verfasserin (orcid)0000-0002-2403-0621 aut Guadagni, Simone verfasserin aut Gianardi, Desirée verfasserin aut Furbetta, Niccolò verfasserin aut Caprili, Giovanni verfasserin aut Fatucchi, Lorenzo Maria verfasserin (orcid)0000-0001-6106-5519 aut Sbrana, Andrea verfasserin aut Funel, Niccola verfasserin aut Pollina, Luca Emanuele verfasserin aut Di Candio, Giulio verfasserin (orcid)0000-0003-2156-369X aut Morelli, Luca verfasserin aut Enthalten in Surgical oncology Amsterdam [u.a.] : Elsevier Science, 1992 38 Online-Ressource (DE-627)32445290X (DE-600)2026613-3 (DE-576)098134388 1879-3320 nnns volume:38 GBV_USEFLAG_U SYSFLAG_U GBV_ELV GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.81 Onkologie 44.65 Chirurgie AR 38 |
| allfields_unstemmed |
10.1016/j.suronc.2021.101582 doi (DE-627)ELV006548989 (ELSEVIER)S0960-7404(21)00071-2 DE-627 ger DE-627 rda eng 610 DE-600 44.81 bkl 44.65 bkl Palmeri, Matteo verfasserin (orcid)0000-0002-9343-278X aut Prognostic impact of conservative surgery for pancreatic IPMNs 2021 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: The extent of pancreatic resection for intraductal papillary mucinous neoplasms (IPMNs) remains an unresolved issue. The study aims at analyzing the prognostic impact of conservative surgery (CS) i.e. of pancreatoduodenectomy or distal pancreatectomy, versus total pancreatectomy (TP), for pancreatic IPMNs.Methods: We retrospectively analyzed and compared data of patients who had undergone pancreatic resection for IPMNs at our center between November 2007 and April 2019. Patients were divided into two main groups based on the extent of surgery: TP-group and CS-group. Subsequently, the perioperative and the long-term outcomes were compared. Moreover, a sub-group analysis of patients with IPMN alone and patients with malignant IPMN, based on preoperative indications to surgery and post-operative histopathological findings, was also performed.Results: Fifty-three patients were included in the TP-group and 73 in the CS-group. In 50 (39.7%) cases the frozen section changed the pre-operative surgical planning, with an extension of the pancreatic resection, in 43 (34.1%) cases up to a total pancreatectomy. Twenty-six patients (20.6%) with low-grade dysplasia at the frozen section underwent CS, while twenty (15.8%) underwent TP. Comparing these two sub-groups no differences were found in surgical IPMN recurrence, nor progression. The rate of overall postoperative complications was 56.6% in the TP-group and 57.5% in the CS-group (p = 0.940). Fifteen patients (20.5%) developed diabetes in the CS-group.Conclusion: A timely CS can be considered an appropriate and valid strategy in the surgical treatment of the majority of pancreatic IPMNs, as it can avoid the serious long-term metabolic consequences of TP in patients with a long-life expectancy. On the contrary, TP remains mandatory in case of PDAC or high-risk features involving the entire gland. IPMN Intraductal papillary mucinous neoplasms Pancreatic surgery Conservative surgery Surgical management Di Franco, Gregorio verfasserin aut Bianchini, Matteo verfasserin (orcid)0000-0002-2403-0621 aut Guadagni, Simone verfasserin aut Gianardi, Desirée verfasserin aut Furbetta, Niccolò verfasserin aut Caprili, Giovanni verfasserin aut Fatucchi, Lorenzo Maria verfasserin (orcid)0000-0001-6106-5519 aut Sbrana, Andrea verfasserin aut Funel, Niccola verfasserin aut Pollina, Luca Emanuele verfasserin aut Di Candio, Giulio verfasserin (orcid)0000-0003-2156-369X aut Morelli, Luca verfasserin aut Enthalten in Surgical oncology Amsterdam [u.a.] : Elsevier Science, 1992 38 Online-Ressource (DE-627)32445290X (DE-600)2026613-3 (DE-576)098134388 1879-3320 nnns volume:38 GBV_USEFLAG_U SYSFLAG_U GBV_ELV GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.81 Onkologie 44.65 Chirurgie AR 38 |
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10.1016/j.suronc.2021.101582 doi (DE-627)ELV006548989 (ELSEVIER)S0960-7404(21)00071-2 DE-627 ger DE-627 rda eng 610 DE-600 44.81 bkl 44.65 bkl Palmeri, Matteo verfasserin (orcid)0000-0002-9343-278X aut Prognostic impact of conservative surgery for pancreatic IPMNs 2021 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: The extent of pancreatic resection for intraductal papillary mucinous neoplasms (IPMNs) remains an unresolved issue. The study aims at analyzing the prognostic impact of conservative surgery (CS) i.e. of pancreatoduodenectomy or distal pancreatectomy, versus total pancreatectomy (TP), for pancreatic IPMNs.Methods: We retrospectively analyzed and compared data of patients who had undergone pancreatic resection for IPMNs at our center between November 2007 and April 2019. Patients were divided into two main groups based on the extent of surgery: TP-group and CS-group. Subsequently, the perioperative and the long-term outcomes were compared. Moreover, a sub-group analysis of patients with IPMN alone and patients with malignant IPMN, based on preoperative indications to surgery and post-operative histopathological findings, was also performed.Results: Fifty-three patients were included in the TP-group and 73 in the CS-group. In 50 (39.7%) cases the frozen section changed the pre-operative surgical planning, with an extension of the pancreatic resection, in 43 (34.1%) cases up to a total pancreatectomy. Twenty-six patients (20.6%) with low-grade dysplasia at the frozen section underwent CS, while twenty (15.8%) underwent TP. Comparing these two sub-groups no differences were found in surgical IPMN recurrence, nor progression. The rate of overall postoperative complications was 56.6% in the TP-group and 57.5% in the CS-group (p = 0.940). Fifteen patients (20.5%) developed diabetes in the CS-group.Conclusion: A timely CS can be considered an appropriate and valid strategy in the surgical treatment of the majority of pancreatic IPMNs, as it can avoid the serious long-term metabolic consequences of TP in patients with a long-life expectancy. On the contrary, TP remains mandatory in case of PDAC or high-risk features involving the entire gland. IPMN Intraductal papillary mucinous neoplasms Pancreatic surgery Conservative surgery Surgical management Di Franco, Gregorio verfasserin aut Bianchini, Matteo verfasserin (orcid)0000-0002-2403-0621 aut Guadagni, Simone verfasserin aut Gianardi, Desirée verfasserin aut Furbetta, Niccolò verfasserin aut Caprili, Giovanni verfasserin aut Fatucchi, Lorenzo Maria verfasserin (orcid)0000-0001-6106-5519 aut Sbrana, Andrea verfasserin aut Funel, Niccola verfasserin aut Pollina, Luca Emanuele verfasserin aut Di Candio, Giulio verfasserin (orcid)0000-0003-2156-369X aut Morelli, Luca verfasserin aut Enthalten in Surgical oncology Amsterdam [u.a.] : Elsevier Science, 1992 38 Online-Ressource (DE-627)32445290X (DE-600)2026613-3 (DE-576)098134388 1879-3320 nnns volume:38 GBV_USEFLAG_U SYSFLAG_U GBV_ELV GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.81 Onkologie 44.65 Chirurgie AR 38 |
| allfieldsSound |
10.1016/j.suronc.2021.101582 doi (DE-627)ELV006548989 (ELSEVIER)S0960-7404(21)00071-2 DE-627 ger DE-627 rda eng 610 DE-600 44.81 bkl 44.65 bkl Palmeri, Matteo verfasserin (orcid)0000-0002-9343-278X aut Prognostic impact of conservative surgery for pancreatic IPMNs 2021 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: The extent of pancreatic resection for intraductal papillary mucinous neoplasms (IPMNs) remains an unresolved issue. The study aims at analyzing the prognostic impact of conservative surgery (CS) i.e. of pancreatoduodenectomy or distal pancreatectomy, versus total pancreatectomy (TP), for pancreatic IPMNs.Methods: We retrospectively analyzed and compared data of patients who had undergone pancreatic resection for IPMNs at our center between November 2007 and April 2019. Patients were divided into two main groups based on the extent of surgery: TP-group and CS-group. Subsequently, the perioperative and the long-term outcomes were compared. Moreover, a sub-group analysis of patients with IPMN alone and patients with malignant IPMN, based on preoperative indications to surgery and post-operative histopathological findings, was also performed.Results: Fifty-three patients were included in the TP-group and 73 in the CS-group. In 50 (39.7%) cases the frozen section changed the pre-operative surgical planning, with an extension of the pancreatic resection, in 43 (34.1%) cases up to a total pancreatectomy. Twenty-six patients (20.6%) with low-grade dysplasia at the frozen section underwent CS, while twenty (15.8%) underwent TP. Comparing these two sub-groups no differences were found in surgical IPMN recurrence, nor progression. The rate of overall postoperative complications was 56.6% in the TP-group and 57.5% in the CS-group (p = 0.940). Fifteen patients (20.5%) developed diabetes in the CS-group.Conclusion: A timely CS can be considered an appropriate and valid strategy in the surgical treatment of the majority of pancreatic IPMNs, as it can avoid the serious long-term metabolic consequences of TP in patients with a long-life expectancy. On the contrary, TP remains mandatory in case of PDAC or high-risk features involving the entire gland. IPMN Intraductal papillary mucinous neoplasms Pancreatic surgery Conservative surgery Surgical management Di Franco, Gregorio verfasserin aut Bianchini, Matteo verfasserin (orcid)0000-0002-2403-0621 aut Guadagni, Simone verfasserin aut Gianardi, Desirée verfasserin aut Furbetta, Niccolò verfasserin aut Caprili, Giovanni verfasserin aut Fatucchi, Lorenzo Maria verfasserin (orcid)0000-0001-6106-5519 aut Sbrana, Andrea verfasserin aut Funel, Niccola verfasserin aut Pollina, Luca Emanuele verfasserin aut Di Candio, Giulio verfasserin (orcid)0000-0003-2156-369X aut Morelli, Luca verfasserin aut Enthalten in Surgical oncology Amsterdam [u.a.] : Elsevier Science, 1992 38 Online-Ressource (DE-627)32445290X (DE-600)2026613-3 (DE-576)098134388 1879-3320 nnns volume:38 GBV_USEFLAG_U SYSFLAG_U GBV_ELV GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.81 Onkologie 44.65 Chirurgie AR 38 |
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Enthalten in Surgical oncology 38 volume:38 |
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Enthalten in Surgical oncology 38 volume:38 |
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Onkologie Chirurgie |
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findex.gbv.de |
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IPMN Intraductal papillary mucinous neoplasms Pancreatic surgery Conservative surgery Surgical management |
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Surgical oncology |
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Palmeri, Matteo @@aut@@ Di Franco, Gregorio @@aut@@ Bianchini, Matteo @@aut@@ Guadagni, Simone @@aut@@ Gianardi, Desirée @@aut@@ Furbetta, Niccolò @@aut@@ Caprili, Giovanni @@aut@@ Fatucchi, Lorenzo Maria @@aut@@ Sbrana, Andrea @@aut@@ Funel, Niccola @@aut@@ Pollina, Luca Emanuele @@aut@@ Di Candio, Giulio @@aut@@ Morelli, Luca @@aut@@ |
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2021-01-01T00:00:00Z |
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Palmeri, Matteo |
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Palmeri, Matteo ddc 610 bkl 44.81 bkl 44.65 misc IPMN misc Intraductal papillary mucinous neoplasms misc Pancreatic surgery misc Conservative surgery misc Surgical management Prognostic impact of conservative surgery for pancreatic IPMNs |
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610 DE-600 44.81 bkl 44.65 bkl Prognostic impact of conservative surgery for pancreatic IPMNs IPMN Intraductal papillary mucinous neoplasms Pancreatic surgery Conservative surgery Surgical management |
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Prognostic impact of conservative surgery for pancreatic IPMNs |
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Palmeri, Matteo Di Franco, Gregorio Bianchini, Matteo Guadagni, Simone Gianardi, Desirée Furbetta, Niccolò Caprili, Giovanni Fatucchi, Lorenzo Maria Sbrana, Andrea Funel, Niccola Pollina, Luca Emanuele Di Candio, Giulio Morelli, Luca |
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prognostic impact of conservative surgery for pancreatic ipmns |
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Prognostic impact of conservative surgery for pancreatic IPMNs |
| abstract |
Background: The extent of pancreatic resection for intraductal papillary mucinous neoplasms (IPMNs) remains an unresolved issue. The study aims at analyzing the prognostic impact of conservative surgery (CS) i.e. of pancreatoduodenectomy or distal pancreatectomy, versus total pancreatectomy (TP), for pancreatic IPMNs.Methods: We retrospectively analyzed and compared data of patients who had undergone pancreatic resection for IPMNs at our center between November 2007 and April 2019. Patients were divided into two main groups based on the extent of surgery: TP-group and CS-group. Subsequently, the perioperative and the long-term outcomes were compared. Moreover, a sub-group analysis of patients with IPMN alone and patients with malignant IPMN, based on preoperative indications to surgery and post-operative histopathological findings, was also performed.Results: Fifty-three patients were included in the TP-group and 73 in the CS-group. In 50 (39.7%) cases the frozen section changed the pre-operative surgical planning, with an extension of the pancreatic resection, in 43 (34.1%) cases up to a total pancreatectomy. Twenty-six patients (20.6%) with low-grade dysplasia at the frozen section underwent CS, while twenty (15.8%) underwent TP. Comparing these two sub-groups no differences were found in surgical IPMN recurrence, nor progression. The rate of overall postoperative complications was 56.6% in the TP-group and 57.5% in the CS-group (p = 0.940). Fifteen patients (20.5%) developed diabetes in the CS-group.Conclusion: A timely CS can be considered an appropriate and valid strategy in the surgical treatment of the majority of pancreatic IPMNs, as it can avoid the serious long-term metabolic consequences of TP in patients with a long-life expectancy. On the contrary, TP remains mandatory in case of PDAC or high-risk features involving the entire gland. |
| abstractGer |
Background: The extent of pancreatic resection for intraductal papillary mucinous neoplasms (IPMNs) remains an unresolved issue. The study aims at analyzing the prognostic impact of conservative surgery (CS) i.e. of pancreatoduodenectomy or distal pancreatectomy, versus total pancreatectomy (TP), for pancreatic IPMNs.Methods: We retrospectively analyzed and compared data of patients who had undergone pancreatic resection for IPMNs at our center between November 2007 and April 2019. Patients were divided into two main groups based on the extent of surgery: TP-group and CS-group. Subsequently, the perioperative and the long-term outcomes were compared. Moreover, a sub-group analysis of patients with IPMN alone and patients with malignant IPMN, based on preoperative indications to surgery and post-operative histopathological findings, was also performed.Results: Fifty-three patients were included in the TP-group and 73 in the CS-group. In 50 (39.7%) cases the frozen section changed the pre-operative surgical planning, with an extension of the pancreatic resection, in 43 (34.1%) cases up to a total pancreatectomy. Twenty-six patients (20.6%) with low-grade dysplasia at the frozen section underwent CS, while twenty (15.8%) underwent TP. Comparing these two sub-groups no differences were found in surgical IPMN recurrence, nor progression. The rate of overall postoperative complications was 56.6% in the TP-group and 57.5% in the CS-group (p = 0.940). Fifteen patients (20.5%) developed diabetes in the CS-group.Conclusion: A timely CS can be considered an appropriate and valid strategy in the surgical treatment of the majority of pancreatic IPMNs, as it can avoid the serious long-term metabolic consequences of TP in patients with a long-life expectancy. On the contrary, TP remains mandatory in case of PDAC or high-risk features involving the entire gland. |
| abstract_unstemmed |
Background: The extent of pancreatic resection for intraductal papillary mucinous neoplasms (IPMNs) remains an unresolved issue. The study aims at analyzing the prognostic impact of conservative surgery (CS) i.e. of pancreatoduodenectomy or distal pancreatectomy, versus total pancreatectomy (TP), for pancreatic IPMNs.Methods: We retrospectively analyzed and compared data of patients who had undergone pancreatic resection for IPMNs at our center between November 2007 and April 2019. Patients were divided into two main groups based on the extent of surgery: TP-group and CS-group. Subsequently, the perioperative and the long-term outcomes were compared. Moreover, a sub-group analysis of patients with IPMN alone and patients with malignant IPMN, based on preoperative indications to surgery and post-operative histopathological findings, was also performed.Results: Fifty-three patients were included in the TP-group and 73 in the CS-group. In 50 (39.7%) cases the frozen section changed the pre-operative surgical planning, with an extension of the pancreatic resection, in 43 (34.1%) cases up to a total pancreatectomy. Twenty-six patients (20.6%) with low-grade dysplasia at the frozen section underwent CS, while twenty (15.8%) underwent TP. Comparing these two sub-groups no differences were found in surgical IPMN recurrence, nor progression. The rate of overall postoperative complications was 56.6% in the TP-group and 57.5% in the CS-group (p = 0.940). Fifteen patients (20.5%) developed diabetes in the CS-group.Conclusion: A timely CS can be considered an appropriate and valid strategy in the surgical treatment of the majority of pancreatic IPMNs, as it can avoid the serious long-term metabolic consequences of TP in patients with a long-life expectancy. On the contrary, TP remains mandatory in case of PDAC or high-risk features involving the entire gland. |
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Di Franco, Gregorio Bianchini, Matteo Guadagni, Simone Gianardi, Desirée Furbetta, Niccolò Caprili, Giovanni Fatucchi, Lorenzo Maria Sbrana, Andrea Funel, Niccola Pollina, Luca Emanuele Di Candio, Giulio Morelli, Luca |
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Twenty-six patients (20.6%) with low-grade dysplasia at the frozen section underwent CS, while twenty (15.8%) underwent TP. Comparing these two sub-groups no differences were found in surgical IPMN recurrence, nor progression. The rate of overall postoperative complications was 56.6% in the TP-group and 57.5% in the CS-group (p = 0.940). Fifteen patients (20.5%) developed diabetes in the CS-group.Conclusion: A timely CS can be considered an appropriate and valid strategy in the surgical treatment of the majority of pancreatic IPMNs, as it can avoid the serious long-term metabolic consequences of TP in patients with a long-life expectancy. 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7.399208 |