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Surgical Clinics of North America

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https://www.readbyqxmd.com/read/29191283/a-symposium-on-pancreatic-cancer-time-for-a-paradigm-shift-an-overview-and-personal-reflections
#1
EDITORIAL
Avram M Cooperman
No abstract text is available yet for this article.
February 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29191282/foreword
#2
EDITORIAL
Ronald F Martin
No abstract text is available yet for this article.
February 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29191281/adjuvant-or-neoadjuvant-therapy-in-the-treatment-in-pancreatic-malignancies-where-are-we
#3
REVIEW
Robert A Wolff
Since the advent of modern surgery for pancreatic cancer, clinicians have recognized this cancer's propensity to recur locally, metastasize, and cause death. Despite significant efforts to improve patient outcomes with better adjuvant therapy, only modest gains in survival have been observed. An alternative strategy of neoadjuvant therapy followed by surgery has the potential to improve patient selection and survival, and expand the pool of patients eligible for curative surgery. This article summarizes large, randomized trials of adjuvant therapy, explains the limitations imposed by up-front surgery, and suggests neoadjuvant therapy as a rational alternative to initial surgery and adjuvant therapy...
February 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29191280/rare-uncommon-and-unusual-complications-after-pancreaticoduodenal-resection
#4
REVIEW
Thinzar M Lwin, Natasha Leigh, Mazen E Iskandar, Justin G Steele, Michael G Wayne, Avram M Cooperman
Complications after pancreaticoduodenal resection occur in at least 30% of patients. Most are a direct result of an intraoperative event, dissection, or anastomoses which account for the most serious morbidities, sepsis, pseudoaneurysms, and hemorrhage. Rarely, complications are due to the systemic impact of the procedure even if the procedure itself was unremarkable. Rare systemic complications after PDR (Transfusion transmitted Babesiosis, pituitary apoplexy, and TRALI) and a number of uncommon and unusual other complications are discussed...
February 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29191279/cancer-of-the-pancreas-actual-5-10-and-20-year-survival-the-lucky-and-fortunate-few
#5
REVIEW
Avram M Cooperman, Howard Bruckner, Harry Snady, Hillel Hammerman, Andrew Fader, Michael Feld, Frank Golier, Tom Rush, Jerome Siegal, Franklin Kasmin, Seth Cohen, Michael G Wayne, Mazen E Iskandar, Justin G Steele
Cancer of the pancreas (CaP) is a dismal, uncommon, systemic malignancy. This article updates an earlier experience of actual long-term survival of CaP in patients treated between 1991 to 2000, and reviews the literature. Survival is expressed as actual, not projected, survival.
February 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29191278/timing-of-pancreatic-resection-and-patient-outcomes-is-there-a-difference
#6
REVIEW
Timothy J Vreeland, Mathew H G Katz
Rates of long-term survival after treatment of pancreatic cancer remain low, in part because most patients are still treated with primary resection. This approach is often inadequate because of early local control failures, early manifestation of metastatic disease because of the unrecognized and untreated systemic component of this disease, and because half of patients never receive multimodal therapy. Preoperative therapy can be used to improve local control and treat the systemic nature of pancreatic cancer while also selecting for patients who benefit from a morbid operation...
February 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29191277/a-tale-of-2-techniques-preoperative-biliary-drainage-and-routine-surgical-drainage-with-pancreaticoduodenectomy
#7
REVIEW
Mazen E Iskandar, Michael G Wayne, Justin G Steele, Avram M Cooperman
Preoperative drainage of an obstructed biliary tree before pancreaticoduodenal resection (PDR) and placement of intraabdominal drains following pancreatic resection have been suggested to be both unnecessary and associated with a higher complication rate. The evidence for and against that practice is presented and analyzed to highlight its risks and benefits. A selective approach on an individual basis for preoperative biliary decompression is advocated, based on multiple factors. Additionally, the evidence for routine use of surgical drains after PDR is critically reviewed and the rationale for routine drainage is made...
February 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29191276/preoperative-stenting-for-benign-and-malignant-periampullary-diseases-unnecessary-if-not-harmful
#8
REVIEW
Sepideh Gholami, Murray F Brennan
Preoperative biliary drainage (PBD) is often performed in patients with jaundice with the presumption that it will decrease the risk of postoperative complications. PBD carries its own risk of complications and, therefore, has been controversial. Multiple randomized controlled trials and metaanalyses have shown that PBD has significantly increased overall complications compared with surgery alone. As such, the routine application of PBD should be avoided except in a subset of clinical situations. This is discussed in detail in this article...
February 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29191275/screening-of-patients-at-risk-for-familial-pancreatic-cancer-what-is-bene%C3%AF-cial
#9
REVIEW
Robert J Torphy, Richard D Schulick
Family history is a significant risk factor for developing pancreatic cancer and this hereditary risk can be secondary to familial cancer predisposition syndromes, hereditary pancreatitis, or familial pancreatic cancer. Certain high-risk individuals are recommended to undergo screening for pancreatic cancer with endoscopic ultrasound or MRI/magnetic resonance retrograde cholangiopancreatography because of the potential to identify and curatively resect precursor lesions. The management of suspicious lesions identified on screening high-risk individuals is also discussed...
February 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29191274/ex%C3%A2-vivo-resection-and-autotransplantation-for-pancreatic-neoplasms
#10
REVIEW
Peter Liou, Tomoaki Kato
There are several low-grade pancreatic tumors whose biology permits the use of aggressive surgery to achieve a curative resection. Tumors that are deemed unresectable by conventional techniques due to mesenteric vessel involvement may benefit from ex vivo tumor resection and autotransplantation to allow complete resection while minimizing ischemic organ injury. Despite the excellent oncologic outcomes when used for these neoplasms, the procedure carries substantial morbidity and a high complication rate. But for patients who were otherwise offered total enterectomy and allotransplantation or told that their tumor was unresectable, ex vivo resection may offer them a hope for cure...
February 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29191273/rare-tumors-and-lesions-of-the-pancreas
#11
REVIEW
John A Stauffer, Horacio J Asbun
There are a few entities that account for most solid and cystic masses of the pancreas. The pancreas harbors a wide array of diseases, including adenocarcinoma, and its variants, such as anaplastic and adenosquamous carcinoma. Other neoplasms include acinar cell carcinoma, solid pseudopapillary tumor, and sarcomas. Benign lesions include hamartomas, hemangiomas, lymphangioma, and plasmacytoma. Isolated metastases include renal cell carcinoma, melanoma, and other carcinomas. Benign inflammatory conditions, such as autoimmune pancreatitis and groove pancreatitis can also mimic solid neoplasms of the pancreas...
February 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29191272/nonfunctioning-incidental-pancreatic-neuroendocrine-tumors-who-when-and-how-to-treat
#12
REVIEW
Marina Gorelik, Mahmoud Ahmad, David Grossman, Martin Grossman, Avram M Cooperman
Asymptomatic non-functioning pancreatic neuroendocrine tumors are indolent, slow-growing tumors, and surveillance is safe and reasonable. Despite consensus, size may be less important than grade and Ki-67 when making decisions regarding optimal therapy. Plans to proceed with surveillance or surgical resection require a multidisciplinary approach and a shared decision making process with colleagues, patients, and families. Decisions should be based on tumor characteristics, patient morbidities, preferences, and risks...
February 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29191271/incidental-intraductal-papillary-mucinous-neoplasm-cystic-or-premalignant-lesions-of-the-pancreas-the-case-for-aggressive-management
#13
REVIEW
Alexander T El Gammal, Jakob R Izbicki
Incidental cystic intrapancreatic lesions are daily findings in abdominal radiology. The discovery of incidental pancreatic lesions is increasingly common with technologic diagnostic advancements. This article provides a perspective and guideline on the clinical management of incidental intraductal papillary mucinous neoplasms and cystic or premalignant lesions of the pancreas.
February 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29191270/preoperative-evaluation-of-a-pancreas-mass-diagnostic-options
#14
REVIEW
Seth Cohen, Alexander C Kagen
As modern abdominal imaging equipment advances, pancreatic lesion detection improves. Most of these lesions are incidental, and present a conundrum to the clinician and create great anxiety to the patient until a final diagnosis is made. For the practicing physician, the plethora of diagnostic options is overwhelming. The relevant question is, what is the most efficient algorithm to follow and to arrive at a timely and accurate diagnosis. This article presents a logical approach to the initial evaluation of a pancreatic lesion to get the most information possible with the least amount of testing, and to avoid duplicative measures...
February 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29191269/nonoperative-ablation-of-pancreatic-neoplasms
#15
REVIEW
Cristina Marrocchio, Susan Dababou, Carlo Catalano, Alessandro Napoli
Pancreatic cancer is a poor prognostic tumor and about 20% of patients are eligible for surgical resection at the time of diagnosis. Recently, minimally invasive procedures have provided promising results as a therapeutic option for locally advanced unresectable pancreatic cancer. In particular, high-intensity focused ultrasound is an emerging noninvasive thermally ablative procedure that may have a dominant role in the future. Although the clinical applications of minimally invasive therapies to pancreatic cancers are still in their infancy, the results at present are promising...
February 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29191268/the-evolving-role-of-radiation-in-pancreatic-cancer
#16
REVIEW
Evan Landau, Shalom Kalnicki
Pancreatic cancer is an aggressive malignancy with a poor long-term survival and only mild improvement in outcomes over the past 30 years. Local failure remains a problem and radiation can help improve control. The role of radiation therapy in has been controversial and is still evolving. This article reviews the trials of pancreatic cancer and radiation in adjuvant, neoadjuvant, and unresectable lesions. The article reviews the impact and outcomes of evolving radiation technology.
February 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29191267/prevention-and-early-detection-of-pancreatic-cancer
#17
REVIEW
Avram M Cooperman, Mazen E Iskandar, Michael G Wayne, Justin G Steele
Preventing cancer has much to offer. Aside from plummeting health care costs, we might enjoy a healthier life free of cancer and chronic disease. Prevention requires the adoption of healthier choices and a moderate amount of exercise. The supporting evidence is observational, clinical, and partly common sense. Further investigations reveal several substances in a whole-food plant-based diet that have protective effects and an inhibitory effect on tumor development. For pancreatic cancer, the basis of cure remains a century old operation that rarely cures...
February 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29132519/what-s-new-in-surgery-critical-care
#18
EDITORIAL
Cynthia L Talley
No abstract text is available yet for this article.
December 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29132518/foreword
#19
EDITORIAL
Ronald F Martin
No abstract text is available yet for this article.
December 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29132517/surgical-critical-care-gastrointestinal-complications
#20
REVIEW
Rowan Sheldon, Matthew Eckert
Critical illness and injury affect the gastrointestinal tract almost uniformly. Complications include the sequelae of direct intestinal injury and repair, impaired motility, intra-abdominal hypertension, and ulceration, among others. Contemporary clinical practice has incorporated many advances in the prevention and treatment of gastrointestinal complications during critical illness. This article discusses the epidemiology, risk factors, means of diagnosis, treatment, and prevention of some of these compilations...
December 2017: Surgical Clinics of North America
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