scholarly journals Short- and long-term outcomes of laparoscopic organ-sparing resection for pancreatic neuroendocrine neoplasms

2020 ◽  
Author(s):  
Renchao Zhang ◽  
Jun Ma ◽  
Yi-Ping Mou ◽  
Yu-Cheng Zhou ◽  
Wei-Wei Jin ◽  
...  
Keyword(s):  
Distal Pancreatectomy ◽  
Neuroendocrine Neoplasms ◽  
Long Term Outcomes ◽  
Pancreatic Neuroendocrine Neoplasms ◽  
Spleen Preserving ◽  
Short And Long Term ◽  
Organ Sparing ◽  
Laparoscopic Enucleation

Abstract BackgroundPancreatic neuroendocrine neoplasms (PNENs) are rare neoplasm with long life expectancy. In this setting, patients may benefit from laparoscopic organ-sparing resection. There are few reports of laparoscopic organ-sparing resection for PNENs. The aim of this study was to evaluate the Short- and long-term outcomes of laparoscopic organ-sparing resection for PNENs.MethodsA retrospective study was performed for patients with PNENs who underwent laparoscopic organ-sparing pancreatectomy between March 2005 and May 2018. The patients’ demographic data, operative results, pathological reports, hospital courses, morbidity and mortality, and follow-up data (including pancreatic function, till August 2018) was analyzed.ResultsThirty-five patients were identified. There were 9 male and 26 female patients, with a median age of 46 years (range, 25-75 years). The mean BMI was 24.6±3.3kg/m2. Nine patients received laparoscopic enucleation, 20 received laparoscopic spleen-preserving distal pancreatectomy, and 6 received laparoscopic central pancreatectomy. The operative time, intraoperative blood loss, transfusion rate, postoperative hospital stay were 186.4±60.2min, 165±73.0ml, 0, 9d(range, 5-23d), respectively. The morbidity rate, ≥Grade Ⅲ complication rate and ≥grade B pancreatic fistula rate were 34.2%, 11.4%, 8.7%, respectively, with no mortality. The rate of follow-up was 94.3%, and the median follow-up time was 55 months (range, 3-158months). One patients had diabetes after laparoscopic spleen-preserving distal pancreatectomy, no patient had symptom of pancreatic exocrine insufficiency. One patient developed recurrence 36 months after laparoscopic enucleation and was managed with surgical resection. The other patients survived without metastases or recurrence during the follow-up.ConclusionsLaparoscopic organ-sparing resection for selected cases of PNENs is safe and feasible, and have favorable short- and long-term outcome.

scholarly journals Short- and long-term outcomes of laparoscopic organ-sparing resection for pancreatic neuroendocrine neoplasms

2020 ◽  
Author(s):  
Ren-Chao Zhang ◽  
Jun Ma ◽  
yiping mou ◽  
Yu-Cheng Zhou ◽  
Wei-Wei Jin ◽  
...  
Keyword(s):  
Distal Pancreatectomy ◽  
Neuroendocrine Neoplasms ◽  
Long Term Outcomes ◽  
Pancreatic Neuroendocrine Neoplasms ◽  
Spleen Preserving ◽  
Short And Long Term ◽  
Organ Sparing ◽  
Laparoscopic Enucleation

Abstract Background Pancreatic neuroendocrine neoplasms (PNENs) are rare neoplasm with long life expectancy. In this setting, patients may benefit from laparoscopic organ-sparing resection. There are few reports of laparoscopic organ-sparing resection for PNENs. The aim of this study was to evaluate the Short- and long-term outcomes of laparoscopic organ-sparing resection for PNENs. Methods A retrospective study was performed for patients with PNENs who underwent laparoscopic organ-sparing pancreatectomy between March 2005 and May 2018. The patients’ demographic data, operative results, pathological reports, hospital courses, morbidity and mortality, and follow-up data (including pancreatic function, till August 2018) was analyzed. Results Thirty-five patients were identified. There were 9 male and 26 female patients, with a median age of 46 years (range, 25-75 years). The mean BMI was 24.6±3.3kg/m 2 . Nine patients received laparoscopic enucleation, 20 received laparoscopic spleen-preserving distal pancreatectomy, and 6 received laparoscopic central pancreatectomy. The operative time, intraoperative blood loss, transfusion rate, postoperative hospital stay were 186.4±60.2min, 165±73.0ml, 0, 9d(range, 5-23d), respectively. The morbidity rate, ≥Grade III complication rate and ≥grade B pancreatic fistula rate were 34.2%, 11.4%, 8.7%, respectively, with no mortality. The rate of follow-up was 94.3%, and the median follow-up time was 55 months (range, 3-158months). One patients had diabetes after laparoscopic spleen-preserving distal pancreatectomy, no patient had symptom of pancreatic exocrine insufficiency. One patient developed recurrence 36 months after laparoscopic enucleation and was managed with surgical resection. The other patients survived without metastases or recurrence during the follow-up. Conclusions Laparoscopic organ-sparing resection for selected cases of PNENs is safe and feasible, and have favorable short- and long-term outcome.

scholarly journals Short- and long-term outcomes of laparoscopic organ-sparing resection for pancreatic neuroendocrine neoplasms

2020 ◽  
Author(s):  
Ren-Chao Zhang ◽  
Jun Ma ◽  
yiping mou ◽  
Yu-Cheng Zhou ◽  
Wei-Wei Jin ◽  
...  
Keyword(s):  
Distal Pancreatectomy ◽  
Neuroendocrine Neoplasms ◽  
Transfusion Rate ◽  
Long Term Outcomes ◽  
Pancreatic Neuroendocrine Neoplasms ◽  
Spleen Preserving ◽  
Short And Long Term ◽  
Organ Sparing

Abstract Background：Pancreatic neuroendocrine neoplasms (PNENs) are rare neoplasms associated with a long life expectancy after resection. In this setting, patients may benefit from laparoscopic organ-sparing resection. Studies of laparoscopic organ-sparing resection for PNENs are limited. The aim of this study was to evaluate the short- and long-term outcomes of laparoscopic organ-sparing resection for PNENs.Methods： A retrospective study was performed for patients with PNENs who underwent laparoscopic organ-sparing pancreatectomy between March 2005 and May 2018. The patients’ demographic data, operative results, pathological reports, hospital courses and morbidity, mortality, and follow-up data (until August 2018) were analysed.Results：Thirty-five patients were included in the final analysis. There were 9 male and 26 female patients, with a median age of 46 years (range, 25-75 years). The mean BMI was 24.6±3.3 kg/m2. Nine patients received laparoscopic enucleation (LE), 20 received laparoscopic spleen-preserving distal pancreatectomy (LSPDP), and 6 received laparoscopic central pancreatectomy. The operative time, intraoperative blood loss, transfusion rate, and postoperative hospital stay were 186.4±60.2 min, 165±73.0 ml, 0 d, and 9 d (range, 5-23 d), respectively. The morbidity rate, grade ≥III complication rate and grade ≥B pancreatic fistula rate were 34.2%, 11.4%, and 8.7%, respectively, with no mortality. The rate of follow-up was 94.3%, and the median follow-up time was 55 months (range, 3-158 months). One patient developed recurrence 36 months after LE and was managed with surgical resection. The other patients survived without metastases or recurrence during the follow-up. One patient had diabetes after laparoscopic spleen-preserving distal pancreatectomy, and no patients had symptoms of pancreatic exocrine insufficiency. Conclusions： Laparoscopic organ-sparing resection for selected cases of PNENs is safe and feasible and has favourable short- and long-term outcomes.

scholarly journals Short- and Long-Term Outcomes of Laparoscopic Organ-Sparing Resection for Pancreatic Neuroendocrine Neoplasms

2020 ◽  
Vol 44 (11) ◽  
pp. 3795-3800
Author(s):  
Ren-Chao Zhang ◽  
Jun Ma ◽  
Yi-Ping Mou ◽  
Yu-Cheng Zhou ◽  
Wei-Wei Jin ◽  
...  
Keyword(s):  
Neuroendocrine Neoplasms ◽  
Long Term Outcomes ◽  
Pancreatic Neuroendocrine Neoplasms ◽  
Short And Long Term ◽  
Organ Sparing

Long-Term Outcomes after Spleen-Preserving Distal Pancreatectomy for Pancreatic Neuroendocrine Tumors: Results from the US Neuroendocrine Study Group

2020 ◽  
Vol 111 (1-2) ◽  
pp. 129-138 ◽  
Author(s):  
Kota Sahara ◽  
Diamantis I. Tsilimigras ◽  
Amika Moro ◽  
Rittal Mehta ◽  
Mary Dillhoff ◽  
...  
Keyword(s):  
Distal Pancreatectomy ◽  
Neuroendocrine Tumors ◽  
Study Group ◽  
Pancreatic Neuroendocrine Tumors ◽  
Long Term Outcomes ◽  
Spleen Preserving ◽  
The Us ◽  
Short And Long Term ◽  
The Impact

<b><i>Background:</i></b> The adoption of spleen-preserving distal pancreatectomy (SPDP) for malignant disease such as pancreatic neuroendocrine tumors (pNETs) has been controversial. The objective of the current study was to assess the impact of SPDP on outcomes of patients with pNETs. <b><i>Methods:</i></b> Patients undergoing a distal pancreatectomy for pNET between 2002 and 2016 were identified in the US Neuroendocrine Tumor Study Group database. Propensity score matching (PSM) was used to compare short- and long-term outcomes of patients undergoing SPDP versus distal pancreatectomy with splenectomy (DPS). <b><i>Results:</i></b> Among 621 patients, 103 patients (16.6%) underwent an SPDP. Patients who underwent SPDP were more likely to have lower BMI (median, 27.5 [IQR 24.0–31.2] vs. 28.7 [IQR 25.7–33.6]; <i>p</i> = 0.005) and have undergone minimally invasive surgery (<i>n</i> = 56, 54.4% vs. <i>n</i> = 185, 35.7%; <i>p</i> &#x3c; 0.001). After PSM, while the median total number of lymph nodes examined among patients who underwent an SPDP was lower compared with DPS (3 [IQR 1–8] vs. 9 [5–13]; <i>p</i> &#x3c; 0.001), 5-year overall survival (OS) and recurrence-free survival (RFS) were comparable (OS: 96.8 vs. 92.0%, log-rank <i>p</i> = 0.21, RFS: 91.1 vs. 84.7%, log-rank <i>p</i> = 0.93). In addition, patients undergoing SPDP had less intraoperative blood loss (median, 100 mL [IQR 10–250] vs. 150 mL [IQR 100–400]; <i>p</i> = 0.001), lower incidence of serious complications (<i>n</i> = 13, 12.8% vs. <i>n</i> = 28, 27.5%; <i>p</i> = 0.014), and shorter length of stay (median: 5 days [IQR 4–7] vs. 6 days [IQR 5–13]; <i>p</i> = 0.049) compared with patients undergoing DPS. <b><i>Conclusion:</i></b> SPDP for pNET was associated with acceptable perioperative and long-term outcomes that were comparable to DPS. SPDP should be considered for patients with pNET.

scholarly journals LAPAROSCOPIC DISTAL PANCREATECTOMY WITH OR WITHOUT SPLEEN PRESERVATION: COMPARATIVE ANALYSIS OF SHORT AND LONG-TERM OUTCOMES

2019 ◽  
Vol 32 (3) ◽  
Author(s):  
Sergio Renato PAIS-COSTA ◽  
Guilherme Costa Crispim de SOUSA ◽  
Sergio Luiz Melo ARAUJO ◽  
Olímpia Alves Teixeira LIMA ◽  
Sandro José MARTINS ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Distal Pancreatectomy ◽  
Laparoscopic Distal Pancreatectomy ◽  
Long Term Outcomes ◽  
Spleen Preservation ◽  
Short And Long Term ◽  
The Mean ◽  
Group 1

ABSTRACT Background: Laparoscopic distal pancreatectomy (LDP) is the preferred approach for resection of tumors in the distal pancreas because of its many advantages over the open approach. Aim: To analyse and compare short and long-term outcomes from LDP performed through two different techniques: with splenectomy vs. spleen preservation and splenic vessel preservation. Method: Fifty-eight patients were operated and subsequently divided between two groups: Group 1, LDP with splenectomy (LDPS); and Group 2, LDP with spleen preservation and preservation of splenic vessels (LDPSPPSV). Results: The epidemiological characteristics were statistically similar between the two groups (age, gender, BMI and lesion size). Both the mean of operative time (p=0.04) and the mean of intra-operative blood loss (p=0,03) were higher in Group 1. The mean of resected lymph nodes was also higher in Group 1 (p<0.000). There were no statistic differences between the groups in relation to open conversion, morbidity or early postoperative mortality. The mean hospital stay was similar between groups. Pancreatic fistula (grade B and C) was similar between the groups. The mean of overall follow-up was 37.6 months (5-96). Late complications were similar between the groups. Conclusion: Both techniques were superimposable; however, LDPS presented, respectively, higher intra-operative bleeding, longer duration of the operation and higher number of lymph nodes resected. No differences were observed in the studied period in relation to the appearance of infections or neoplasm related to splenectomy during follow-up. Maintenance of the spleen avoided periodic immunizations in patients in LDPSPSV. It is indicated in small pancreatic lesions with indolent course.

Infective endocarditis in patients who use IV drugs: a single centre cohort

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
H Alraddadi ◽  
A Alsagheir ◽  
S Gao ◽  
K An ◽  
H Hronyecz ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Infective Endocarditis ◽  
Long Term Outcomes ◽  
Replacement Surgery ◽  
Short Term Mortality ◽  
History Of ◽  
Short And Long Term ◽  
Baseline Characteristics

Abstract Background Managing endocarditis in intravenous drug use (IVDU) patients is challenging: unless patients successfully quit IVDU, the risk of re-infection is high. Clinicians often raise concerns with ethical and resource allocation principles when considering valve replacement surgery in this patient population. To help inform practice, we sought to determine the long-term outcomes of IVDU patients with endocarditis who underwent valve surgery in our center. Method After research ethics board approval, infective endocarditis cases managed surgically at our General Hospital between 2009 and 2018 were identified through the Cardiac Care Network. We reviewed patients' charts and included those with a history of IVDU in this study. We abstracted data on baseline characteristics, peri-operative course, short- and long-term outcomes. We report results using descriptive statistics. Results We identified 124 IVDU patients with surgically managed endocarditis. Mean age was 37 years (SD 11), 61% were females and 8% had redo surgery. During admission, 45% (n=56) of the patients had an embolic event: 63% pulmonary, 30% cerebral, 18% peripheral and 11% mesenteric. Causative organisms included Methicillin-Sensitive Staphylococcus Aureus (51%, n=63), Methicillin-Resistant Staphylococcus Aureus (15%, n=19), Streptococcus Viridans (2%, n=2), and others (31%, n=38). Emergency cardiac surgery was performed for 42% of patients (n=52). Most patients (84%) had single valve intervention: 53% tricuspid, 18% aortic and 13% mitral. Double valve interventions occurred in 15% (n=18). Overall, bioprosthetic replacement was most commonly chosen (79%, n=98). In-hospital mortality was 7% (n=8). Median length of stay in hospital was 13 days (IQR 8,21) and ICU 2 days (IQR 1,6). Mortality at longest available follow-up was 24% (n=30), with a median follow-up of 129 days (IQR 15,416). Valve reintervention rate was 11% (n=13) and readmission rate was 14% (n=17) at a median of 275 days (IQR 54,502). Conclusion Despite their critical condition, IVDU patients with endocarditis have good intra-hospital outcomes. Challenges occur after hospital discharge with loss of follow-up and high short-term mortality. IVDU relapse likely accounts for some of these issues. In-hospital and community comprehensive addiction management may improve these patients' outcomes beyond the surgical procedure. Annual rate 2009–2018 Funding Acknowledgement Type of funding source: None

Abstract 19771: Persistent Thrombocytopenia after Myocardial Infarction is Associated with Increased Short- and Long-Term Mortality

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Anirudh Kumar ◽  
Salim Virani ◽  
Scott Bassett ◽  
Mahboob Alam ◽  
Ravi Hira ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Bleeding Complications ◽  
Group Differences ◽  
Long Term Outcomes ◽  
Post Discharge ◽  
Short And Long Term ◽  
The Impact ◽  
Long Term Mortality

Background: Thrombocytopenia (TCP) occurs commonly in patients hospitalized with acute myocardial infarction (AMI). It is unclear whether persistent TCP after discharge among AMI survivors is associated with worse outcomes. Methods: We examined the impact of persistent post-discharge TCP on outcomes in a registry of consecutive AMI patients hospitalized between January 2004 and December 2007. In-hospital (IH) TCP was defined by a nadir platelet count < 150 x 109/L. Resolved TCP was defined as IH TCP which resolved within 3 months after discharge while persistent TCP was defined as IH TCP which did not resolve within 3 months. Results: Of 842 patients hospitalized for a first AMI, we examined data on 617 hospital survivors who had follow-up within 3 months of discharge and documented long-term outcomes. Of those, 474 (76.8%) patients did not experience IH TCP while 42 (6.8%) and 101 (16.4%) had persistent and resolved TCP, respectively (Table). Patients with persistent TCP were older, had worse comorbidities, and were more likely to have TCP at baseline and discharge. There were no inter-group differences in infarct size, major bleeding complications, revascularization, or ejection fraction at discharge. Mortality following discharge was higher at all time-points among AMI patients with persistent TCP compared to patients with resolved or without IH TCP (Figure). Patients with resolved TCP had comparable mortality to those without IH TCP. Conclusion: Persistent TCP within 3 months after hospital discharge for AMI is associated with significantly increased short- and long-term mortality compared to patients with recovered TCP or without IH TCP.

scholarly journals Liver Transplantation from Voluntary Organ Donor System in China: A Comparison between DBD and DCD Liver Transplants

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Wei Chen ◽  
Dipesh Kumar Yadav ◽  
Xueli Bai ◽  
Jianying Lou ◽  
Risheng Que ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Organ Donation ◽  
Survival Rates ◽  
Organ Donor ◽  
Long Term Outcomes ◽  
Significant Difference ◽  
Short And Long Term ◽  
Donor System

Background. In China, the cases of liver transplantation (LT) from donation after citizens’ death have rose year by year since the citizen-based voluntary organ donor system was initiated in 2010. The objective of our research was to investigate the early postoperative and late long-term outcomes of LT from donation after brain death (DBD) and donation after circulatory death (DCD) according to the current organ donation system in China. Methods. Sixty-two consecutive cases of LT from donation after citizens’ death performed in our hospital between February 2012 and June 2017 were examined retrospectively for short- and long-term outcomes. These included 35 DCD LT and 27 DBD LT. Result. Subsequent median follow-up time of 19 months and 1- and 3-year graft survival rates were comparative between the DBD group and the DCD group (81.5% and 66.7% versus 67.1% and 59.7%; P=0.550), as were patient survival rates (85.2% and 68.7% versus 72.2% and 63.9%; P=0.358). The duration of ICU stay of recipients was significantly shorter in the DBD group, in comparison with that of the DCD group (1 versus 3 days, P=0.001). Severe complication incidence (≥grade III) after transplantation was identical among the DBD and DCD groups (48.1% versus 60%, P=0.352). There was no significant difference in postoperative mortality between the DBD and DCD groups (3 of 27 cases versus 5 of 35 cases). Twenty-one grafts (33.8%) were lost and 18 recipients (29.0%) were dead till the time of follow-up. Malignancy recurrence was the most prevalent reason for patient death (38.8%). There was no significant difference in incidence of biliary stenosis between the DBD and DCD groups (5 of 27 cases versus 6 of 35 cases, P=0.846). Conclusion. Although the sample size was small to some extent, this single-center study first reported that LT from DCD donors showed similar short- and long-term outcomes with DBD donors and justified the widespread implementation of voluntary citizen-based deceased organ donation in China. However, the results should be verified with a multicenter larger study.

scholarly journals Warshaw Technique in Laparoscopic Spleen-Preserving Distal Pancreatectomy: Surgical Strategy and Late Outcomes of Splenic Preservation

2019 ◽  
Vol 2019 ◽  
pp. 1-10
Author(s):  
Lei Wang ◽  
Dong Wu ◽  
Yu-gang Cheng ◽  
Jian-wei Xu ◽  
Hai-bo Chu ◽  
...  
Keyword(s):  
Distal Pancreatectomy ◽  
Splenic Abscess ◽  
Healthy Population ◽  
Low Grade ◽  
Efficient Treatment ◽  
Spleen Preserving ◽  
Significant Difference ◽  
Splenic Vessels

Laparoscopic spleen-preserving distal pancreatectomy (LSPDP) can be accomplished with either the preservation or the resection of splenic vessels; the latter is also known as Warshaw technique. Our study is designed to investigate the operation selection strategy when proceeding LSPDP and to evaluate the long-term outcomes of patients undergoing Warshaw surgery. The medical records and follow-up data of patients who underwent LSPDP in Qilu Hospital, Shandong University, were reviewed retrospectively. A total of thirty-five patients were involved in this study, including 17 cases of patients who were treated with Warshaw procedure (WT) while the other 18 cases had splenic vessels preserved (SVP). Compared with the SVP group, the operative time and intraoperative blood loss in WT group were improved significantly. The incidence of early postoperative splenic infarction was higher in WT group. However, there was no report of splenic abscess or second operation. Follow-up data confirmed that there was no significant difference in spleen phagocytosis and immune function compared with normal healthy population. Our study confirms that LSPDP-Warshaw procedure is a safe and efficient treatment for the benign or low grade malignant tumors in distal pancreas in selected patients. The long-term spleen function is normal after Warshaw procedure. Preoperative assessment and intraoperative exploration are recommended for the selection of operation approaches.

Sign in / Sign up

Export Citation Format

Share Document