Database : MEDLINE
Search on : Duodenal and Neoplasms [Words]
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[PMID]: 29450630
[Au] Autor:Shibasaki S; Suda K; Nakauchi M; Nakamura T; Kadoya S; Kikuchi K; Inaba K; Uyama I
[Ad] Address:Department of Surgery, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan.
[Ti] Title:Outermost layer-oriented medial approach for infrapyloric nodal dissection in laparoscopic distal gastrectomy.
[So] Source:Surg Endosc;32(4):2137-2148, 2018 Apr.
[Is] ISSN:1432-2218
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:BACKGROUND: Based on our experience of suprapancreatic nodal dissection in laparoscopic gastrectomy, we developed an outermost layer-oriented medial approach for infrapyloric nodal dissection. The objective of this single-institution retrospective study was to determine the feasibility, safety, and reproducibility of this novel and unique dissection procedure. METHODS: This approach can be performed in the same manner as suprapancreatic nodal dissection but by replacing the left gastric artery with the right gastroepiploic artery (RGEA), the common hepatic artery with the anterior superior pancreaticoduodenal artery (ASPDA), and the splenic artery with the gastroduodenal artery. It comprises five steps: (1) mobilization of the transverse mesocolon along the prepancreatic membrane, (2) medial dissection along the dissectable layer between the pancreatic head and the dorsal side of the right gastroepiploic vein (RGEV), (3) division of the RGEV and determination of the lateral and cranial borders, (4) dissection along the outermost layer of the RGEA and ASPDA and transection of the infrapyloric artery and RGEA, and (5) transection of the duodenal bulb. RESULTS: This novel method was applied in 112 patients who underwent laparoscopic distal gastrectomy from 2014 to 2015. The anatomical landmarks that we determined to appropriately identify the outermost layer were highly reproducible, and our novel procedure based on these landmarks was successfully completed in all cases, without any intraoperative complications. Furthermore, in all cases, no. 6 lymph nodes were fully and adequately dissected within the infrapyloric area anatomically defined in the Japanese Classification of Gastric Carcinoma ver. 14. Pancreatic fistula occurred only in 1.8% cases. CONCLUSIONS: This novel outermost layer-oriented medial approach is a robust procedure that may help laparoscopic surgeons in performing safe and reproducible infrapyloric nodal dissection.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:In-Data-Review
[do] DOI:10.1007/s00464-018-6111-6

  2 / 16079 MEDLINE  
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[PMID]: 29480844
[Au] Autor:Wang X; Jin M; Ye Q; Wang M; Hu Y; Yang Y; Yang J; Cai J
[Ad] Address:Department of Oncology, First Affiliated Hospital of Yangtze University, Jingzhou.
[Ti] Title:Solitary duodenum metastasis from breast cancer with 8 years' latency: A case report.
[So] Source:Medicine (Baltimore);97(2):e9550, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:RATIONALE: Advanced breast cancer frequently metastasizes to the lungs, liver, and bones. Metastatic involvement of the duodenal bulb is extremely rare and difficult to detect by endoscopy. PATIENT CONCERNS: A 51-year-old menopausal woman presented with abdominal fullness and obstructive symptoms, and was diagnosed with adenocarcinoma in the duodenal bulb. The patient had undergone modified radical mastectomy of the left breast for infiltrating ductal carcinoma (IDC) 8 years previously. DIAGNOSIS: Metastatic infiltration of the duodenal bulb originating from IDC was proven histologically and immunohistochemically. INTERVENTIONS: She received chemotherapy with docetaxel and capecitabine followed by hormone maintenance therapy with letrozole after operation. OUTCOMES: After treatment, the patient recovered well. She is currently being followed up. LESSONS: Patients with known breast cancer history with the IDC histological type and presenting with nonspecific abdominal symptoms or signs, such as abdominal fullness, nausea, and vomiting, should undergo endoscopy with histopathological examination in order to detect possible gastrointestinal metastasis of the primary breast tumor. This report intends to alert people to heed this type of breast cancer metastasis and not treat it as a primary gastrointestinal tumor.
[Mh] MeSH terms primary: Breast Neoplasms/pathology
Carcinoma, Ductal, Breast/pathology
Duodenal Neoplasms/secondary
[Mh] MeSH terms secundary: Diagnosis, Differential
Duodenal Neoplasms/drug therapy
Duodenal Neoplasms/pathology
Duodenal Neoplasms/surgery
Female
Humans
Middle Aged
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180227
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009550

  3 / 16079 MEDLINE  
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[PMID]: 29465605
[Au] Autor:Wang R; Zhou K; Fan Q; Chen H; Fan C
[Ad] Address:Department of Nuclear Medicine, West China Hospital of Sichuan University, Guoxue Alley, Chengdu, Sichuan, People's Republic of China.
[Ti] Title:A false-positive I-131 finding of duodenum diverticulum in thyroid cancer evaluation by SPECT/CT: A case report.
[So] Source:Medicine (Baltimore);97(8):e9997, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:RATIONALE: Iodine-131 (I-131) is a sensitive marker for the detection of differentiated thyroid cancer (DTC). I-131 whole-body scintigraphy (WBS) has been used widely in evaluation of DTC patient. However, I-131 WBS exists many false-positive uptake of I-131 because radioiodine uptake can also be seen in healthy tissue or in a variety of benign and malignant non-thyroidal tumors. PATIENT CONCERNS: A 44-year-old woman with a papillary thyroid carcinoma for the purpose of ablation therapy after a total thyroidectomy. I-131 WBS showed intensive uptake by thyroid remnant. Meanwhile, a focus of increased activity was seen in right upper abdomen. DISGNOSES, INTERVENTIONS AND OUTCOMES: Based on an I-131 single-photon emission computed tomography/computed tomography (SPECT/CT) fusion imaging combining a Tc-99m pertechnetate dynamic SPECT scan and SPECT/CT fusion imaging with oral administration of iodine contrast agent, a descending duodenum diverticulum was diagnosed. This patient was then treated with conservative treatment, such as diet regulation, rest, appropriate use of antacids and antispasmodic agents, etc. So far, she recovered uneventfully with no any complications. LESSONS: Duodenum diverticulum is a rare false-positive uptake of I-131, it might be a diagnostic challenge when there are many false-positive uptake of I-131 in evaluation of DTC. So it must be significant to be familiar with these physiologic and pathologic variants of I-131 uptake and make further efforts to accurately interpret radioiodine scintigraphy results.
[Mh] MeSH terms primary: Diverticulum/diagnostic imaging
Duodenal Diseases/diagnostic imaging
Iodine Radioisotopes
Single Photon Emission Computed Tomography Computed Tomography
Thyroid Neoplasms/diagnostic imaging
[Mh] MeSH terms secundary: Adult
Carcinoma, Papillary
Diverticulum/etiology
Duodenal Diseases/etiology
False Positive Reactions
Female
Humans
Single Photon Emission Computed Tomography Computed Tomography/methods
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Nm] Name of substance:0 (Iodine Radioisotopes); 0 (Iodine-131)
[Em] Entry month:1803
[Cu] Class update date: 180302
[Lr] Last revision date:180302
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009997

  4 / 16079 MEDLINE  
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[PMID]: 29468272
[Au] Autor:Bartel MJ; Puri R; Brahmbhatt B; Chen WC; Kim D; Simons-Linares CR; Stauffer JA; Buchanan MA; Bowers SP; Woodward TA; Wallace MB; Raimondo M; Asbun HJ
[Ad] Address:Department of Gastroenterology, Mayo Clinic, Jacksonville, FL, USA.
[Ti] Title:Correction to: Endoscopic and surgical management of nonampullary duodenal neoplasms.
[So] Source:Surg Endosc;, 2018 Feb 21.
[Is] ISSN:1432-2218
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:This article was updated to correct the author listing for Carlos Roberto Simons-Linares.
[Pt] Publication type:PUBLISHED ERRATUM
[Em] Entry month:1802
[Cu] Class update date: 180222
[Lr] Last revision date:180222
[St] Status:Publisher
[do] DOI:10.1007/s00464-018-6117-0

  5 / 16079 MEDLINE  
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[PMID]: 29392469
[Au] Autor:Bartel MJ; Puri R; Brahmbhatt B; Chen WC; Kim D; Simons-Linares CR; Stauffer JA; Buchanan MA; Bowers SP; Woodward TA; Wallace MB; Raimondo M; Asbun HJ
[Ad] Address:Department of Gastroenterology, Mayo Clinic, Jacksonville, FL, USA.
[Ti] Title:Endoscopic and surgical management of nonampullary duodenal neoplasms.
[So] Source:Surg Endosc;, 2018 Feb 01.
[Is] ISSN:1432-2218
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:BACKGROUND: Sporadic nonampullary duodenal neoplasms (SNADN) can have malignant potential for which endoscopic and surgical resections are offered. We report combined gastroenterologic and surgical experience for treatment of SNADN, including endoscopic mucosal resection (EMR) and pancreas-preserving partial duodenectomy (PPPD). METHODS: We retrospectively reviewed 121 consecutive patients, who underwent 30 PPPDs and 91 EMRs for mucosal and submucosal SNADN. Decision to undergo EMR or surgical resection was based on expert endoscopist and surgeon discretion including multidisciplinary tumor board review. Main outcomes were recurrence rate of neoplasia and adverse events requiring hospital admission or prolonged care. EMRs were performed with submucosal lifting followed by snare resection. PPPD included total duodenectomy, supra-ampullary PPPD for neoplasms proximal to the ampulla, and infra-ampullary PPPD for lesions distal to the ampulla. Follow-up data were available for 65% of EMR and 73% of surgical patients. RESULTS: Surgically resected neoplasia was larger with more advanced neoplasia and submucosal lesions. En bloc resection was achieved in all surgical resections and in 53% of EMRs. Post-EMR, mucosal and submucosal neoplasia recurred in 32 and 0%, respectively, including five neoplasms (26%) after an initial negative esophagogastroduodenoscopy. All recurrences were treated endoscopically. Complications occurred in 14 endoscopically and eight surgically treated patients, none requiring surgical intervention. CONCLUSIONS: Post-EMR patients had higher recurrence of mucosal neoplasia, whereas submucosal neoplasms, mainly carcinoid, did not recur. Polyp size and positive resection margin were not associated with neoplasia recurrence. Patients with SNADN could benefit from a multidisciplinary approach to stratify the optimal treatment based on local expertise.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180222
[Lr] Last revision date:180222
[St] Status:Publisher
[do] DOI:10.1007/s00464-017-5994-y

  6 / 16079 MEDLINE  
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[PMID]: 29443782
[Au] Autor:Yamasaki M; Funaishi K; Saito N; Sakano A; Fujihara M; Daido W; Ishiyama S; Deguchi N; Taniwaki M; Ohashi N; Hattori N
[Ad] Address:Department of Respiratory Disease, Hiroshima Red Cross Hospital & Atomic Bomb Survivors Hospital, Naka-ku.
[Ti] Title:Putative lung adenocarcinoma with epidermal growth factor receptor mutation presenting as carcinoma of unknown primary site: A case report.
[So] Source:Medicine (Baltimore);97(7):e9942, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:RATIONALE: Only a few cases of putative lung adenocarcinoma presenting as carcinoma of unknown primary site (CUP) with epidermal growth factor receptor (EGFR) mutation have been reported, and the efficacy of EGFR-tyrosine kinase inhibitors (TKIs) for these cases is unclear. PATIENT CONCERNS AND DIAGNOSES: A 67-year-old man complained of paresis of the right lower extremity, dysarthria, and memory disturbance. Computed tomography and magnetic resonance imaging showed multiple brain tumors with brain edema and swelling of the left supraclavicular, mediastinal, and upper abdominal lymph nodes. Moreover, a metastatic duodenal tumor was detected via upper gastrointestinal endoscopy examination. The biopsy specimen of the lesion was examined and was diagnosed as adenocarcinoma with CK7 and TTF-1 positivity. Finally, the case was diagnosed as EGFR mutation-positive putative lung adenocarcinoma presenting as CUP. INTERVENTIONS AND OUTCOMES: Oral erlotinib, an EGFR-TKI, was administered at 150 mg daily. Five weeks later, the brain lesions and several swollen lymph nodes showed marked improvement, and the symptoms of the patient also improved. Three months later, the duodenal lesion was undetected on upper gastrointestinal endoscopy. After an 8-month follow-up, the patient was well with no disease progression. LESSONS: Putative lung adenocarcinoma presenting as CUP may have EGFR mutation, and EGFR-TKI therapy may be effective for such malignancy.
[Mh] MeSH terms primary: Adenocarcinoma/genetics
Lung Neoplasms/genetics
Mutation
Neoplasms, Unknown Primary
Receptor, Epidermal Growth Factor/genetics
[Mh] MeSH terms secundary: Adenocarcinoma/drug therapy
Aged
Antineoplastic Agents/therapeutic use
Erlotinib Hydrochloride/therapeutic use
Humans
Lung Neoplasms/drug therapy
Male
Protein Kinase Inhibitors/therapeutic use
Receptor, Epidermal Growth Factor/antagonists & inhibitors
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Nm] Name of substance:0 (Antineoplastic Agents); 0 (Protein Kinase Inhibitors); DA87705X9K (Erlotinib Hydrochloride); EC 2.7.10.1 (Receptor, Epidermal Growth Factor)
[Em] Entry month:1802
[Cu] Class update date: 180220
[Lr] Last revision date:180220
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180215
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009942

  7 / 16079 MEDLINE  
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[PMID]: 29309111
[Au] Autor:Ignjatovic M; Bezmarevic M; Cerovic S
[Ti] Title:Solitary extramedullary plasmacytoma of the duodenum and pancreas: A case report and review of the literature.
[So] Source:Vojnosanit Pregl;73(4):402-7, 2016 Apr.
[Is] ISSN:0042-8450
[Cp] Country of publication:Serbia
[La] Language:eng
[Ab] Abstract:Introduction: The extramedullary plasmacytomas (EMPs) are rare tumors of plasma cell disorders which are rarely found in the duodenum. We presented a case of solitary EMPs involving the duodenum and pancreas successfully treated by surgical resection after failure of chemotherapy. Case Report: A 55-year-old female with previously diagnosed solitary EMP of the duodenum was admitted to our institution after failure of three cycles of vincristine, adriablastine, dexamethasone (VAD) chemotherapy regimen with an upper gastrointestinal obstruction. On admission computed tomography of the abdomen showed tumor in the region of the second part of duodenum and uncinate process of the pancreas with a complete duodenal obstruction. Intraoperatively a tumor formation was in the region of the second duodenal part, originated from the wall of duodenum with the total diameter of 7 x 5 cm, covering the entire circumference of duodenal wall leaded to a narrowing of duodenal lumen to the thigh gap with an upper gastrointestinal obstruction. Infiltration in the head of the pancreas and uncinate process were also found. The Whipple's procedure was performed but postoperative course was complicated by rapidly refilling chylous ascites which was resolved 4 days after the surgery. Conclusion: Each patient with gastrointestinal EMPs should be considered separately and in timely manner, thus adequate treatment could provide local disease control.
[Mh] MeSH terms primary: Duodenal Neoplasms/pathology
Pancreatic Neoplasms/pathology
Plasmacytoma/pathology
[Mh] MeSH terms secundary: Antineoplastic Combined Chemotherapy Protocols/therapeutic use
Duodenal Neoplasms/drug therapy
Duodenal Neoplasms/surgery
Female
Humans
Intestinal Obstruction/etiology
Middle Aged
Neoplasm Invasiveness
Pancreatic Neoplasms/drug therapy
Pancreatic Neoplasms/surgery
Plasmacytoma/drug therapy
Plasmacytoma/surgery
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Entry month:1802
[Cu] Class update date: 180213
[Lr] Last revision date:180213
[Js] Journal subset:IM
[Da] Date of entry for processing:180109
[St] Status:MEDLINE
[do] DOI:10.2298/VSP141031142I

  8 / 16079 MEDLINE  
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[PMID]: 28470686
[Au] Autor:Sideras K; Biermann K; Yap K; Mancham S; Boor PPC; Hansen BE; Stoop HJA; Peppelenbosch MP; van Eijck CH; Sleijfer S; Kwekkeboom J; Bruno MJ
[Ad] Address:Department of Gastroenterology and Hepatology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands.
[Ti] Title:Tumor cell expression of immune inhibitory molecules and tumor-infiltrating lymphocyte count predict cancer-specific survival in pancreatic and ampullary cancer.
[So] Source:Int J Cancer;141(3):572-582, 2017 08 01.
[Is] ISSN:1097-0215
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Understanding the mechanisms of immune resistance in pancreatic and ampullary cancers is crucial for the development of suitable biomarkers and effective immunotherapeutics. Our aim was to examine the expression of the immune inhibiting molecules PD-L1, Galectin-9, HVEM, IDO and HLA-G, as well as CD8+ and FoxP3+ tumor infiltrating lymphocytes (TIL), in pancreatic and ampullary cancers, and to relate their individual, as well as their combined expression, to cancer survival. Tumor tissue from 224 patients with resected pancreatic (n = 148) and ampullary (n = 76) cancer was used to construct tissue-microarrays. Expression of immune inhibitory molecules and TIL was examined by immunohistochemistry. We show that immune inhibitory molecules are prevalently expressed. Moreover, high tumor expression of PD-L1 (p = 0.002), Gal-9 (p = 0.003), HVEM (p = 0.001), IDO (p = 0.049), HLA-G (p = 0.004) and high CD8/FoxP3 TIL ratio (p = 0.006) were associated with improved cancer-specific survival. All immune biomarkers, with the exception of IDO, were individually predictive of cancer-specific survival when adjusted for clinicopathologic characteristics. For every additional immune biomarker present survival was almost two-fold prolonged (HR 0.57 95%CI 0.47-0.69, p < 0.0001). When patients with pancreatic and ampullary cancer were analyzed separately the results were similar. We conclude that pancreas and ampullary cancers are rich in expression of immune-inhibitory molecules. These molecules can be targets for future immunotherapeutics, as well as form powerful immunological biomarkers. We propose that such immune biomarker panels be included in future prospective immunotherapy trials.
[Mh] MeSH terms primary: B7-H1 Antigen/metabolism
Common Bile Duct Neoplasms/mortality
Galanin/metabolism
HLA-G Antigens/metabolism
Indoleamine-Pyrrole 2,3,-Dioxygenase/metabolism
Lymphocytes, Tumor-Infiltrating/immunology
Pancreatic Neoplasms/mortality
Receptors, Tumor Necrosis Factor, Member 14/metabolism
[Mh] MeSH terms secundary: Adult
Aged
Aged, 80 and over
Ampulla of Vater/immunology
Ampulla of Vater/metabolism
Biomarkers, Tumor/metabolism
Common Bile Duct Neoplasms/immunology
Common Bile Duct Neoplasms/metabolism
Female
Humans
Lymphocytes, Tumor-Infiltrating/metabolism
Lymphocytes, Tumor-Infiltrating/pathology
Male
Middle Aged
Pancreatic Neoplasms/immunology
Pancreatic Neoplasms/metabolism
Prognosis
Retrospective Studies
[Pt] Publication type:JOURNAL ARTICLE
[Nm] Name of substance:0 (B7-H1 Antigen); 0 (Biomarkers, Tumor); 0 (CD274 protein, human); 0 (GAL protein, human); 0 (HLA-G Antigens); 0 (Indoleamine-Pyrrole 2,3,-Dioxygenase); 0 (Receptors, Tumor Necrosis Factor, Member 14); 0 (TNFRSF14 protein, human); 88813-36-9 (Galanin)
[Em] Entry month:1710
[Cu] Class update date: 180208
[Lr] Last revision date:180208
[Js] Journal subset:IM
[Da] Date of entry for processing:170505
[St] Status:MEDLINE
[do] DOI:10.1002/ijc.30760

  9 / 16079 MEDLINE  
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[PMID]: 28461144
[Au] Autor:Bourgouin S; Ewald J; Mancini J; Moutardier V; Delpero JR; Le Treut YP
[Ad] Address:Aix-Marseille University, APHM La Conception, Department of Surgery and Liver Transplantation, Marseille, France; Sainte Anne Military Teaching Hospital, Department of Oncologic and Digestive Surgery, Toulon, France. Electronic address: stephane_bourgouin@hotmail.fr.
[Ti] Title:Disease-free survival following resection in non-ductal periampullary cancers: A retrospective multicenter analysis.
[So] Source:Int J Surg;42:103-109, 2017 Jun.
[Is] ISSN:1743-9159
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Predictors of recurrence following pancreaticoduodenectomy are well described for ductal periampullary cancers but lack reliability for non-ductal tumors. The purpose of this study is to analyze the disease-free survival (DFS) and to define the predictors of recurrence following resection for ampullary (AC), bile duct (BDC) and duodenal cancers (DC). MATERIALS AND METHODS: Clinico-pathological data of patients operated on between 2001 and 2011 were retrospectively reviewed. The effect of lymphatic invasion was specified using the lymph node ratio (LNR) and the number of positive nodes (NPN), with thresholds calculated with the likelihood ratio. Kaplan-Meier disease-free survival (DFS) curves were compared for all covariates by a log-rank test. Multivariate logistic regression analyses were performed to identify predictors of recurrence. RESULTS: 135 patients were identified. Mean follow-up was 49 ± 35 months. Median DFS was not reached for AC and was 36 and 18 months for DC and BDC, respectively. Five-year DFS was 52%, 43% and 32% for AC, DC and BDC, respectively. Predictors of recurrence were T4 tumors, neural invasion and preoperative biliary drainage for DC, ≥3 positive nodes and ≥4% loss of BMI for AC, and T3-T4 tumors for BDC. CONCLUSION: Loss of BMI ≥4% is a strong predictor of recurrence in AC, and the recurrence risk increases with the total number of lymph nodes invaded (0; 1-3; ≥4). Only T stage influences recurrence for BDC. Considering DC, the adverse effect of preoperative biliary drainage should be validated in randomized series.
[Mh] MeSH terms primary: Ampulla of Vater
Common Bile Duct Neoplasms/surgery
Duodenal Neoplasms/surgery
Pancreaticoduodenectomy
[Mh] MeSH terms secundary: Adult
Aged
Aged, 80 and over
Ampulla of Vater/surgery
Common Bile Duct Neoplasms/mortality
Common Bile Duct Neoplasms/pathology
Disease-Free Survival
Duodenal Neoplasms/mortality
Duodenal Neoplasms/pathology
Female
Humans
Male
Middle Aged
Retrospective Studies
[Pt] Publication type:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Entry month:1801
[Cu] Class update date: 180131
[Lr] Last revision date:180131
[Js] Journal subset:IM
[Da] Date of entry for processing:170503
[St] Status:MEDLINE

  10 / 16079 MEDLINE  
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[PMID]: 29352442
[Au] Autor:Ojima T; Nakamori M; Nakamura M; Hayata K; Katsuda M; Takifuji K; Yamaue H
[Ad] Address:Second Department of Surgery, Wakayama Medical University School of Medicine, 811-1, Kimiidera, Wakayama, 641-8510, Japan.
[Ti] Title:Laparoscopic and Endoscopic Cooperative Surgery Versus Endoscopic Submucosal Dissection for the Treatment of Low-Risk Tumors of the Duodenum.
[So] Source:J Gastrointest Surg;, 2018 Jan 19.
[Is] ISSN:1873-4626
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: There have been no comparative studies of endoscopic submucosal dissection (ESD) and laparoscopic and endoscopic cooperative surgery (LECS) for patients with duodenal tumors regarding surgical outcomes. The aim of this study is to compare the safety and feasibility of short-term surgical outcomes of ESD and LECS for patients with low-risk tumors of the duodenum. METHODS: This was a single-center retrospective study of 68 consecutive patients with low-risk tumors of the duodenum who received surgical treatments. ESD (n = 50) was performed between 2000 and 2013 and LECS (n = 18) was performed between 2014 and 2017. RESULTS: The overall incidence of perioperative complications was significantly higher in the ESD group (28%) than in the LECS group (0%) (P = 0.014). In the ESD group, eight patients with intraoperative perforation of duodenum (16%) were repaired with metal clips. Postoperative duodenal hemorrhage occurred in three patients (6%). Postoperative duodenal stricture requiring endoscopically guided balloon dilation was observed in two patients (4%). Postoperative bile leakage was found in one patient (2%). The size of resected lesion was significantly larger in the LECS group (26.5 mm) than in the ESD group (14.5 mm) (P = 0.003). In LECS group, all 18 patients underwent curative resection; however, the curative resection rate was 52% in ESD group (P = 0.001). CONCLUSION: LECS for patients with low-risk tumors of the duodenum is a safe, feasible, and ideal alternative to ESD with regard to short-term surgical outcomes. TRIAL REGISTRATION: UMIN000021200 ( http://www.umin.ac.jp/ctr/ ).
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180120
[Lr] Last revision date:180120
[St] Status:Publisher
[do] DOI:10.1007/s11605-018-3680-6


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