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https://www.readbyqxmd.com/read/29149478/hospital-quality-patient-risk-and-medicare-expenditures-for-cancer-surgery
#1
Sarah P Shubeck, Jyothi R Thumma, Justin B Dimick, Hari Nathan
BACKGROUND: Surgical resection is a cornerstone of curative-intent therapy for patients with solid organ malignancies. With increasing attention paid to the costs of surgical care, there is a new focus on variations in the costs of cancer surgery. This study evaluated the potential interactive effect of hospital quality and patient risk on expenditures for cancer resections. METHODS: With 100% Medicare claim data for 2010-2013, patients aged 65 to 99 years who had undergone cancer resection were identified...
November 17, 2017: Cancer
https://www.readbyqxmd.com/read/29146108/pancreatectomy-for-pancreatic-incidentaloma-what-are-the-risks
#2
Morgane Bouquot, Sébastien Gaujoux, François Cauchy, David Birnbaum, Safi Dokmak, Philippe Levy, Olivier Soubrane, Alain Sauvanet
BACKGROUND: Pancreatic incidentalomas (PI) are nowadays common but the benefit-risk balance of surgery remains difficult to determine. METHODS: Monocentric retrospective study of 881 pancreatectomies comparing resected PI with symptomatic lesion. Univariate and multivariate (MV) analyses were done to identify risk factors of malignancy in PI undergoing surgery. RESULTS: Overall, 32% of pancreatectomies were performed for PI. Median size of PI was 30 mm (vs 28 mm; p = 0...
November 7, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/29143477/gastric-venous-congestion-and-bleeding-in-association-with-total-pancreatectomy
#3
Akimasa Nakao, Suguru Yamada, Tsutomu Fujii, Haruyoshi Tanaka, Kenji Oshima, Yukiko Oshima, Kiyotsugu Iede, Hironobu Kobayashi, Yasunori Kimura, Yasuhiro Kodera
BACKGROUND: Gastric venous congestion and bleeding in association with total pancreatectomy (TP) were evaluated. METHODS: Thirty-eight patients of TP were retrospectively analyzed. TP was classified as TP with distal gastrectomy (TPDG), pylorus-preserving TP (PPTP), subtotal stomach-preserving TP (SSPTP), and TP with segmental duodenectomy (TPSD). RESULTS: Portal vein or superior mesenteric vein resection and reconstruction was performed in 24 patients (62...
November 16, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/29139589/severe-fasting-hypoglycemia-in-a-child-after-total-pancreatectomy-with-islet-autotransplantation
#4
Jacob M Redel, Jaimie D Nathan, Maisam Abu-El-Haija, Tom K Lin, Joseph J Palermo, Deborah A Elder
TPIAT is an increasingly utilized treatment option for select children with CP. Post-TPIAT fasting hypoglycemia, unrelated to exogenous insulin, is a complication recently reported in adults. This phenomenon has not been described in children. We review a case of severe fasting hypoglycemia in an adolescent female occurring 10 months post-TPIAT. A 12-year-old girl underwent TPIAT for CP. Ten months postoperatively she developed recurrent hypoglycemia on a total daily insulin dose of 0.03 units/kg. Consequently, insulin therapy was discontinued...
November 15, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29138379/-a-case-of-advanced-gastric-cancer-responding-to-neoadjuvant-chemotherapy-with-docetaxel-cisplatin-and-5-fluorouracil-leading-to-a-pathological-complete-response
#5
Keishi Kawasaki, Dan Takeuchi, Takaaki Kaneko, Seiki Miura, Junichiro Kamiya, Yoji Miyahara, Kotaro Yoshimura, Akira Ogata
We report a 72-year-old woman who was initially diagnosed with locally advanced gastric cancer with involvement of the esophagus and pancreas. She received 3 courses of neoadjuvant chemotherapy(NAC)with docetaxel, cisplatin, and 5- fluorouracil(the DCF regimen)and achieved an excellent response. She underwent total gastrectomy with distal pancreatectomy, splenectomy, and D2 lymphadenectomy. Histological examination confirmed a pathological complete response. NAC chemotherapy can down stage/down size the disease and allow some patients to undergo curative radical surgery...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29137016/binding-pancreaticogastrostomy-anastomosis-in-central-pancreatectomy-a-single-center-experience
#6
Pengcheng Kang, Zhidong Wang, Kaiming Leng, Xiangyu Zhong, Hao Wang, Ming Wan, Sheng Tai, Yunfu Cui
A growing number of central pancreatectomies are performed. However, reconstruction of pancreaticoenteral digestive continuity after central pancreatectomy remains debated. This study evaluates the short-term outcomes of binding pancreaticogastrostomy anastomosis in central pancreatectomy.We have reviewed our experience with 52 patients who underwent binding pancreaticogastrostomy following central pancreatectomy from February 2009 to March 2015. Indication includes 6 noninvasive intraductal papillary mucinous neoplasms, 11 neuroendocrine tumors, 12 solid pseudopapillary tumor, 9 serous cystadenoma, 6 mucinous cystadenoma, and 8 focal pancreatic traumas...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29137001/reply-to-the-letter-to-the-editor-laparoscopic-distal-pancreatectomy-for-pancreatic-ductal-adenocarcinoma-time-for-a-randomized-controlled-trial-results-of-an-all-inclusive-national-observational-study
#7
https://www.readbyqxmd.com/read/29137000/laparoscopic-distal-pancreatectomy-for-pancreatic-ductal-adenocarcinoma-time-for-a-randomized-controlled-trial-results-of-an-all-inclusive-national-observational-study
#8
Thijs de Rooij, Jony van Hilst, Olivier R Busch, Marcel G Dijkgraaf, David A Kooby, Mohammed Abu Hilal, Marc G Besselink
No abstract text is available yet for this article.
December 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29135123/hepatobiliary-and-pancreatic-procedures-during-cytoreductive-surgery-and-hipec
#9
Ioannis Kyriazanos, Nikolaos Kopanakis, Vasileios Kalles, Alexios Tzivanakis, Georgios Nikolaou, Elias Efstathiou, John Spiliotis
PURPOSE: The combination of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has been used as locoregional treatment in selected patients with peritoneal malignancy. The purpose of this study was to report on the outcomes of patients undergoing hepatobiliary and pancreatic procedures during CRS and HIPEC. METHODS: A prospectively maintained database was used to identify patients that underwent hepatobilliary and/or pancreatic procedures during CRS and HIPEC...
September 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/29134966/total-pancreatectomy-and-islet-autotransplant-in-the-treatment-of-chronic-pancreatitis-tread-very-very-carefully
#10
Timothy B Gardner, Kerrington D Smith
No abstract text is available yet for this article.
November 14, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29134352/accuracy-of-apparent-diffusion-coefficient-in-differentiating-pancreatic-neuroendocrine-tumour-from-intrapancreatic-accessory-spleen
#11
Ankur Pandey, Pallavi Pandey, Mounes Aliyari Ghasabeh, Farnaz Najmi Varzaneh, Pegah Khoshpouri, Nannan Shao, Manijeh Zargham Pour, Daniel Fadaei Fouladi, Ralph H Hruban, Anne Marie O'Broin-Lennon, Ihab R Kamel
OBJECTIVES: To evaluate and compare the accuracy of absolute apparent diffusion coefficient (ADC) and normalised ADC (lesion-to-spleen ADC ratio) in differentiating pancreatic neuroendocrine tumour (NET) from intrapancreatic accessory spleen (IPAS). METHODS: Study included 62 patients with the diagnosis of pancreatic NET (n=51) or IPAS (n=11). Two independent reviewers measured ADC on all lesions and spleen. Receiver operating characteristics (ROC) analysis to differentiate NET from IPAS was performed and compared for absolute and normalised ADC...
November 13, 2017: European Radiology
https://www.readbyqxmd.com/read/29133263/prospective-evaluation-of-pasireotide-in-patients-undergoing-pancreaticoduodenectomy-the-washington-university-experience
#12
Ismael Dominguez-Rosado, Ryan C Fields, Cheryl A Woolsey, Gregory Williams, Timothy A Horwedel, J Bart Rose, Chet W Hammill, Maria B Doyle, William C Chapman, Steven M Strasberg, William G Hawkins, Dominic E Sanford
BACKGROUND: Pasireotide is a newer generation somatostatin analogue which led to a significant reduction in pancreatic fistula after pancreatectomy in a single-center randomized controlled trial. We sought to determine if pasireotide reduces the incidence of pancreatic fistula and other complications following pancreaticoduodenectomy at our high volume center. STUDY DESIGN: All patients between April 2011 and January 2017 undergoing pancreaticoduodenectomy were prospectively followed and their complications graded using the Modified Accordion Grading System (MAGS) in our institutional complications database...
November 10, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29131920/congenital-hyperinsulinism
#13
Elena Minakova, Alison Chu
Congenital hyperinsulinism is a rare disorder that commonly presents in the immediate postnatal period as persistent hypoglycemia. The condition is frequently resistant to medical therapies, and the genetic mutations implicated in the disorder can be predictive of response to therapy. Evaluation of hypoglycemia in the illustrative case presented in this article led to genetic testing identifying recessive mutations in the potassium channel subunits of the beta-islet pancreatic cells. Potassium channel defects are often refractory to medical therapies, so near-total pancreatectomy is usually indicated; however, genetic mutations leading to metabolic dysregulation within the beta-islet pancreatic cells are usually responsive to medical therapy...
November 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/29124843/splenic-vessel-preservation-versus-splenic-vessel-resection-in-laparoscopic-spleen-preserving-distal-pancreatectomy
#14
Baohua Hou, Dailan Xiong, Sheng Chen, Tingting Ma, Chuanzhao Zhang, Yu Zhou, Zi Yin
BACKGROUND: Laparoscopic spleen-preserving distal pancreatectomy for low-grade malignant pancreas tumours was recently demonstrated and can be performed with splenic vessel preservation (SVP) or splenic vessel resection (SVR). Whether one approach is superior to another is still a matter of debate. METHODS: A systematic literature search (PubMed, Embase, Science Citation Index, Springer-Link and Cochrane Central Register of Controlled Trials) was performed. Pooled intra- and post-operative outcomes were evaluated...
November 9, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29124023/resection-for-pancreatic-cancer-lung-metastases
#15
Masayuki Okui, Takashi Yamamichi, Ayaka Asakawa, Masahiko Harada, Hirotoshi Horio
Background: Pancreatic cancer is a highly aggressive solid tumor. Patients with metastases from pancreatic cancer have poor survival rates. Here, we report the outcomes of 6 patients for whom resection of lung metastases was performed after a pancreatectomy to treat pancreatic cancer. Methods: We retrospectively reviewed the perioperative clinical data of patients with lung metastases resulting from primary pancreatic cancer who were treated with lung resection between 2008 and 2015...
October 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29123358/chronic-cancer-pain-diagnostic-dilemma-and-management-challenges
#16
Deepti Ahuja, Sachidanand Jee Bharati, Seema Mishra, Sushma Bhatnagar
A 32-year-old female, diagnosed case of neuroendocrine tumor of pancreas, was admitted to the pain and palliative care unit with complaints of diffuse abdominal pain which was severe in intensity with score on numerical rating scale-9/10. Pain was not relieved even after taking tablet morphine immediate release 360 mg every 4 hourly, paracetamol 500 mg 6 hourly, and gabapentin 300 mg 8 hourly. She had undergone distal pancreatectomy with splenectomy and also received multiple lines of chemotherapy. After making a diagnosis of opioid-induced hyperalgesia, opioid rotation from morphine to fentanyl was done...
October 2017: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/29122707/robotic-versus-laparoscopic-distal-pancreatectomy-a-comparative-study-of-clinical-outcomes-and-costs-analysis
#17
Benedetto Ielpo, Hipolito Duran, Eduardo Diaz, Isabel Fabra, Riccardo Caruso, Luis Malavé, Valentina Ferri, Sara Lazzaro, Denis Kalivaci, Yolanda Quijano, Emilio Vicente
BACKGROUND: The robotic surgery cost presents a critical issue which has not been well addressed yet. This study aims to compare the clinical outcomes and cost differences of robotic distal pancreatectomy (RDP) versus laparoscopic distal pancreatectomy (LDP). METHODS: Data were abstracted prospectively from 2011 to 2017. An independent company performed the financial analysis. RESULTS: A total of 28 RDP and 26 LDP were included. The mean operative time was significantly lower in the LDP (294 vs 241 min; p = 0...
November 6, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29121944/first-experience-of-robotic-spleen-preserving-distal-pancreatectomy-in-a-child-with-insulinoma
#18
Ming-Gen Hu, Yuan-Hong Xiao, Dong-Da Song, Guo-Dong Zhao, Yan-Zhe Liu, Zheng Wang, Hao-Yu Li, Rong Liu
BACKGROUND: An insulinoma is a functional neuroendocrine pancreatic tumor, and surgical resection is indicated. Robot-assisted laparoscopic surgeries have been shown to be generally safe and feasible for treatment of pediatric cases of urologic and digestive disease. CASE PRESENTATION: In July 2016, a 9-year-old girl (24 kg, 120 cm) was admitted with a pancreatic tail insulinoma and underwent robot-assisted spleen-preserving laparoscopic distal pancreatectomy...
November 9, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29121885/robotic-versus-laparoscopic-distal-pancreatectomy-an-up-to-date-meta-analysis
#19
Gian Piero Guerrini, Andrea Lauretta, Claudio Belluco, Matteo Olivieri, Marco Forlin, Stefania Basso, Bruno Breda, Giulio Bertola, Fabrizio Di Benedetto
BACKGROUND: Laparoscopic distal pancreatectomy (LDP) reduces postoperative morbidity, hospital stay and recovery as compared with open distal pancreatectomy. Many authors believe that robotic surgery can overcome the difficulties and technical limits of LDP thanks to improved surgical manipulation and better visualization. Few studies in the literature have compared the two methods in terms of surgical and oncological outcome. The aim of this study was to compare the results of robotic (RDP) and laparoscopic distal pancreatectomy...
November 9, 2017: BMC Surgery
https://www.readbyqxmd.com/read/29121584/a-case-report-of-primary-pancreatic-leiomyosarcoma-requiring-six-additional-resections-for-recurrences
#20
Shinichiro Makimoto, Kotaro Hatano, Naoki Kataoka, Tomoyuki Yamaguchi, Masafumi Tomita, Eisei Nishino
INTRODUCTION: Primary pancreatic leiomyosarcoma is extremely rare. We report a case in which six additional resections were required to treat recurrent tumors in a 5-year period following the primary operation. PRESENTATION OF CASE: A 69-year-old man presented with a pancreatic tumor. Abdominal computed tomography scan showed a large heterogeneous mass with a necrotic area arising from the pancreatic body. We performed distal pancreatectomy, splenectomy, and wide resection of the transverse mesocolon...
October 27, 2017: International Journal of Surgery Case Reports
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