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https://www.readbyqxmd.com/read/28088597/phase-ii-randomized-trial-of-negative-pressure-wound-therapy-to-decrease-surgical-site-infection-in-patients-undergoing-laparotomy-for-gastrointestinal-pancreatic-and-peritoneal-surface-malignancies
#1
Perry Shen, Aaron Blackham, Stacey Lewis, Clancy Clark, Russell Howerton, Harveshp Mogal, Rebecca Dodson, Gregory B Russell, Edward A Levine
BACKGROUND: Surgical site infections (SSI) remain a major source of morbidity and cost after resection of intra-abdominal malignancies. Negative pressure wound therapy (NPWT) has been reported to significantly reduce SSI when applied to the closed laparotomy incision. This paper reports results of a randomized clinical trial examining the effect of NPWT on SSI rates in surgical oncology patients with increased risk for infectious complications. STUDY DESIGN: From 2012-2016, 265 patients underwent open resection of intra-abdominal neoplasms stratified into three groups: gastrointestinal (n=57), pancreas (n=73), and peritoneal surface malignancy (n=135)...
January 11, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28079542/development-and-validation-of-a-multi-institutional-preoperative-nomogram-for-predicting-grade-of-dysplasia-in-intraductal-papillary-mucinous-neoplasms-ipmns-of-the-pancreas-a-report-from-the-pancreatic-surgery-consortium
#2
Marc A Attiyeh, Carlos Fernández-Del Castillo, Mohammad Al Efishat, Anne A Eaton, Mithat Gönen, Ruqayyah Batts, Ilaria Pergolini, Neda Rezaee, Keith D Lillemoe, Cristina R Ferrone, Mari Mino-Kenudson, Matthew J Weiss, John L Cameron, Ralph H Hruban, Michael I D'Angelica, Ronald P DeMatteo, T Peter Kingham, William R Jarnagin, Christopher L Wolfgang, Peter J Allen
OBJECTIVE: Previous nomogram models for patients undergoing resection of intraductal papillary mucinous neoplasms (IPMNs) have been relatively small single-institutional series. Our objective was to improve upon these studies by developing and independently validating a new model using a large multiinstitutional dataset. SUMMARY BACKGROUND DATA: IPMNs represent the most common radiographically identifiable precursor lesions of pancreatic cancer. They are a heterogenous group of neoplasms in which more accurate markers of high-grade dysplasia or early invasive carcinoma could help avoid unnecessary surgery in 1 case and support potentially curative intervention (resection) in another...
September 20, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/28072751/duodenal-plexiform-fibromyxoma-as-a-cause-of-obscure-upper-gastrointestinal-bleeding-a-case-report
#3
Demetrios Moris, Evangelia Spanou, Stavros Sougioultzis, Nikolaos Dimitrokallis, Polyxeni Kalisperati, Ioanna Delladetsima, Evangelos Felekouras
RATIONALE: We are reporting the first-to our knowledge-case of duodenal Plexiform Fibromyxoma causing obscure upper gastrointestinal bleeding. PATIENT CONCERNS: Plexiform fibromyxoma triggered recurrent upper gastrointestinal bleeding episodes in a 63-year-old man who remained undiagnosed, despite multiple hospitalizations, extensive diagnostic workups and surgical interventions (including gastrectomies), for almost 17 years. DIAGNOSES-INTERVENTIONS: During hospitalization for the last bleeding episode, an upper gastrointestinal endoscopy revealed an intestinal hemorrhagic nodule...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28069033/preoperative-predictors-for-early-recurrence-of-resectable-pancreatic-cancer
#4
Kohei Nishio, Kenjiro Kimura, Ryosuke Amano, Sadaaki Yamazoe, Go Ohrira, Bunzo Nakata, Kosei Hirakawa, Masaichi Ohira
BACKGROUND: The first-line treatment for resectable pancreatic cancer (RPC) is surgical resection. However, our patients have often experienced early recurrence after curative resection for RPC, with desperately poor prognosis. Some reports indicated that minimally distant metastasis not detected at operation might cause early recurrence. The present study aimed to identify preoperative clinicopathological features of early recurrence after curative resection of RPC. METHODS: Ninety RPC patients who underwent curative resection between 2000 and 2014 at our institution were retrospectively analyzed...
January 10, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28068959/pancreatic-neuroendocrine-tumor-with-metastasis-to-the-spleen-a-case-report
#5
Yasunaru Sakuma, Yoshikazu Yasuda, Naohiro Sata, Yoshinori Hosoya, Atsushi Shimizu, Hirofumi Fujii, Daisuke Matsubara, Noriyuki Fukushima, Atsushi Miki, Misato Maeno, Alan Kawarai Lefor
BACKGROUND: Long-term term survival in patients with pancreatic neuroendocrine tumors has been reported, even in patients with metastatic disease. Metastases to the spleen are extremely rare, but have been reported from a number of primary malignancies, such as breast cancer, lung cancer, melanoma and ovarian cancer. This is the first report of a splenic metastasis from a primary pancreatic neuroendocrine tumor. CASE PRESENTATION: The patient presented as a 53 years old white male with anemia and fatigue...
January 9, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28067489/fluorescent-strips-of-electrospun-fibers-for-ratiometric-sensing-of-serum-heparin-and-urine-trypsin
#6
Long Zhao, Tao Wang, Qiang Wu, Yuan Liu, Zhoujiang Chen, Xiaohong Li
"Turn-on" or "turn off" probes remain challenges in the establishmwnt of sensitive, easily operated and reliable methods for in situ monitoring bioactive substances. In the current study, electrospun fibrous strips are designed to provide straightforward observations of ratiometric color changes with naked eyes in the presence of serum heparin or urine trypsin. A tetraphenylethene (TPE) derivative is constructed and, along with phloxine B, is grafted on fibers, followed by protamine adsorption to induce static quenching of phloxine B and aggregation-induced emission of the TPE derivative...
January 9, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/28065242/advances-in-glycemic-characteristics-complications-and-treatment-for-patients-undergoing-total-pancreatectomy
#7
Ying Zhou, Wei-Gang Zhao
Total pancreatectomy has been mainly used to treat malignant diseases of the pancreas, di-ffuse ductal involvement, and severe chronic pancreatitis. Patients may develop pancreatic diabetes after the surgery, in whom the glucose levels fluctuate widely and are hard to control, which increases the incidence of recurrent hypoglycemia. Postoperative complications are closely associated with the glucose levels. Thus, tighter glycemic management is essential for increasing the survival of these patients. Few cases have been discribed in China...
December 20, 2016: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/28050442/pancreatic-tuberculosis-a-puzzle-for-physicians-a-rare-case-and-review-of-literature
#8
Prashanth Ashok Kumar, Gursharan Singh, John Biku Joseph, S Swaminathan, L Venkatakrishnan
Pancreatic Tuberculosis is an uncommon form of extra pulmonary tuberculosis that resembles malignancy of pancreas and serve as a diagnostic challenge for physicians. Conservative management with Anti Tuberculosis Therapy (ATT) will suffice for pancreatic tuberculosis whereas a malignancy may require major surgeries which may lead to significant morbidity. Here, we discuss the case of a female patient who presented with abdominal pain and vomiting and is a known case of chronic calcific pancreatitis. Radiological findings were that of malignancy of the pancreas...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28048258/su-f-r-47-quantitative-shape-relationship-analysis-of-ptv-modification-for-critical-anatomy-sparing-and-its-impact-on-pathologic-response-for-neoadjuvant-stereotactic-radiotherapy-for-pancreatic-cancer
#9
Z Cheng, L Rosati, L Chen, S Robertson, J Moore, L Peng, O Mian, A Narang, A Hacker-Prietz, J Herman, T McNutt
PURPOSE: Stereotactic body radiation therapy (SBRT) may be used to increase surgery candidacy in borderline resectable (BRPC) and locally advanced (LAPC) pancreatic cancer. However, the planning target volume (PTV) may need to be limited to avoid toxicity when the gross tumor volume (GTV) is anatomically involved with surrounding critical structures. Our study aims to characterize the coverage of GTV and investigate the association between modified PTV and pathologic (pCR) or near pathologic (npCR) complete response rates determined from the surgical specimen...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28028341/solid-pseudopapillary-tumor-of-pancreas-a-lesser-known-entity-diagnosis-and-pitfalls-a-case-report
#10
Anshu Singh, Gyanendra Mohan, Sunanda Chaturvedi, Lalatendu Sarangi
Solid pseudopapillary tumor (SPT) is a rare pancreatic neoplasm with a reported incidence of 0.1% to 2.7% of all pancreatic tumors. Because radiological presentation of pancreatic tumors is quite overlapping, distinctive features in fine needle aspiration cytology (FNAC) helps in its diagnosis preoperatively. Being a low-grade malignancy presenting predominantly in young females, correct preoperative diagnosis minimizes the need of extensive surgery. SPT carries good prognosis without any adjuvant chemotherapy/radiotherapy in most cases, even in the presence of metastatic disease...
October 2016: Journal of Cytology
https://www.readbyqxmd.com/read/28024213/long-sleeve-working-port-assisted-laparoscopic-pancreaticoduodenectomy-a-new-technique-in-laparoscopic-surgery
#11
Ying Jun Chen, Wan Yee Lau, Zuo Jun Zhen, Yin Tao He
INTRODUCTION: Advances in technology and instruments have made laparoscopic pancreaticoduodenectomy (LPD) feasible. Unfortunately, this operation is technically very challenging and it is not widely accepted by laparoscopic surgeons. PRESENTATION OF CASE: A 59-year-old woman underwent LPD using a newly invented long-sleeve-working-port (LSWP) for a mucinous cystadenoma of the head of pancreas. This case report describes this port and its use on this patient. DISCUSSION: LSWP is a new invention to facilitate difficult laparoscopic operations...
December 14, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28011495/granulocyte-colony-stimulating-factor-producing-anaplastic-carcinoma-of-the-pancreas-case-report-and-review-of-the-literature
#12
Sarah Vinzens, Joel Zindel, Martin Zweifel, Tilman Rau, Beat Gloor, Annette Wochner
We report on the case of a 67-year-old man with granulocyte colony-stimulating factor (G-CSF) producing anaplastic carcinoma of the pancreas. Preoperative routine tests revealed an elevated white blood cell (WBC) count of 25.2 G/l, consisting almost exclusively of neutrophilic granulocytes (23.31 G/l) with a predominance of segmented neutrophils (78% of all neutrophilic granulocytes), and elevated levels of C-reactive protein at 87 mg/l. Upon surgery, local tumour infiltration was more extensive than expected from preoperative imaging...
January 2017: Anticancer Research
https://www.readbyqxmd.com/read/28005639/pancreatic-uptake-by-18f-fdopa-pet-ct-in-patients-with-hypoglycemia-after-gastric-bypass-surgery-compared-with-controls-with-or-without-carbidopa-pretreatment
#13
André P van Beek, Loek J M de Heide, Bram van Ginkel, Riemer H J A Slart, Anouk N A van der Horst-Schrivers, Ronald Boellaard, Elisabeth G E de Vries, Walter Noordzij, Andor W J M Glaudemans
PURPOSE: The use of Fluorine-labeled dihydroxy-phenyl-alanine (F-FDOPA) PET/CT in patients with hypoglycemia suspected to be caused by pancreatic disease can be helpful to localize the source of excess insulin production. In this setting, carbidopa pretreatment is not recommended. However, quantitative comparisons of pancreatic tracer uptake in patients with or without carbidopa pretreatment and in diffuse pancreatic disease are lacking. Therefore, we aimed to describe and quantify pancreatic F-FDOPA uptake in patients without pancreatic disease with or without carbidopa pretreatment and in patients with hypoglycemia after gastric bypass surgery...
December 21, 2016: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28004852/splenic-preservation-in-laparoscopic-distal-pancreatectomy
#14
M-H Dai, N Shi, C Xing, Q Liao, T-P Zhang, G Chen, W-M Wu, J-C Guo, Z-W Liu, Y-P Zhao
BACKGROUND: Laparoscopic spleen-preserving distal pancreatectomy (LSPDP) is designed principally for the removal of benign and low-grade malignant lesions in the left pancreas. The aims of this study were to compare LSPDP with laparoscopic distal pancreatectomy with splenectomy (LDPS), compare two splenic preservation techniques (splenic vessel preservation and Warshaw technique) and investigate factors that influence splenic preservation. METHODS: Information from patients who underwent laparoscopic distal pancreatectomy between December 2004 and January 2016 at a single institution was reviewed...
December 22, 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/28002540/gallbladder-carcinoma-a-rare-cause-of-pyloric-duodenal-stenosis
#15
Zizi Niculescu, Victoria Ulmeanu, Mihaela Maria Ghinea, Liliana Mocanu, Costin Niculescu, Mircea Grigorian
Pyloric duodenal stenosis is usually caused by pyloric, juxtapyloric or duodenal ulcer, or by postbulbar ulcer. Gallbladder cancer (GBC), duodenal diverticula, annular pancreas and superior mesenteric artery syndrome (Wilkie's syndrome) are rare causes of pyloric duodenal stenosis. The case of a 66-year-old female patient is presented. The patient was admitted to hospital presenting anorexia, repeated alimentary vomiting, epigastric pain, and weight loss. Objective clinical examination upon admission: clapotage à jeun is present, triggered by tapping the epigastric region...
2016: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/27995452/an-optimal-approach-for-laparoscopic-d3-lymphadenectomy-plus-complete-mesocolic-excision-d3-cme-for-right-sided-colon-cancer
#16
Daxing Xie, Chaoran Yu, Chun Gao, Hasan Osaiweran, Junbo Hu, Jianping Gong
BACKGROUND: It is common knowledge that high ligation of blood vessels at the D3 level and complete mesocolic excision (CME) are two critical points of right hemicolectomy for right colon cancer (RCC). (1-5) To date, a safe strategy for completing these two procedures under laparoscopic surgery has not been extensively described. The authors provide a video to demonstrate laparoscopic right hemicolectomy (D3 + CME) with an optimal mesentery-defined approach. By identifying three "tri-junctions," this approach facilitates dissection of the entire mesocolon along the embryologic planes as far centrally as possible and enables the high tie of feeding vessels at bifurcation...
December 19, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27987098/a-surgical-department-for-intensified-care
#17
Pierluigi di Sebastiano, Tommaso Grottola, Anna Maysse, Maria Marino, Francesco Zavattaro, Pas Quale Flacco, F Francesco di Mola
PURPOSE: The growing pressure to rationalize costs in the healthcare system demands the development of new healthcare models aimed at allowing patients to receive the best treatment, without ignoring the rising costs. METHODS: In the Healthcare Unit 2 located in the Abruzzo region in Italy, a new model of intensified care surgical department was designed in January 2013. The department was based on the selection of the degree of patient disease. Patients requiring a medium-low degree surgery were treated in the peripheral unit, in the Ortona hospital, while more complex surgical procedures, most cancer cases (including stomach, liver, pancreas, colon-rectum or multi-organ resections), were performed in the central unit in the Chieti hospital...
December 16, 2016: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/27959944/bemer-electromagnetic-field-therapy-reduces-cancer-cell-radioresistance-by-enhanced-ros-formation-and-induced-dna-damage
#18
Katja Storch, Ellen Dickreuter, Anna Artati, Jerzy Adamski, Nils Cordes
Each year more than 450,000 Germans are expected to be diagnosed with cancer subsequently receiving standard multimodal therapies including surgery, chemotherapy and radiotherapy. On top, molecular-targeted agents are increasingly administered. Owing to intrinsic and acquired resistance to these therapeutic approaches, both the better molecular understanding of tumor biology and the consideration of alternative and complementary therapeutic support are warranted and open up broader and novel possibilities for therapy personalization...
2016: PloS One
https://www.readbyqxmd.com/read/27958619/evaluation-of-urgent-multivisceral-resections-due-to-complications-resulting-from-an-advanced-ovarian-cancer
#19
Tomasz Miłek, Witold Woźniak, Piotr Porzycki, Alkalayla Habib, Agnieszka Timorek, Piotr Ciostek, Włodzimierz Sawicki, Krzysztof Cendrowski
BACKGROUND: Unlike other solid tumors (i.e. pancreas, gallbladder, stomach), an ovarian cancer is responsive to a systemic treatment with platinum derivates in 80% of patients. This apparent chemosensitivity justifies a broader surgical approach. A cytoreductive, "tumor-debulking" surgery is defined as an attempt to remove in a maximum degree all visible and detect-able lesions. Despite treatment, the advancement of the disease very often leads to complications defined as "surgical" and life-threatening...
2016: Ginekologia Polska
https://www.readbyqxmd.com/read/27938531/pancreas-divisum-correlation-between-anatomical-abnormalities-and-bile-precipitation-in-the-gallbladder-in-seven-patients
#20
P Izzo, P Di Cello, F Pugliese, S Izzo, Romualdo Grande, F Biancucci, G Sinaimeri, F Razionale, U Costi, M Al Mansour, A Muneer, S Valabrega, L Izzo
Pancreas divisum is a genetic defect associated with recurrent acute pancreatitis due to insufficient drainage of the accessory pancreatic duct. Seven young patients diagnosed with pancreatic divisum and thickening of the gallbladder bile as shown on magnetic resonance cholangio-pancreatography without pancreatic ductal changes underwent laparoscopic cholecystectomy. During the mean follow-up of 32 months no episode of pancreatitis was reported. There is an association between PD and higher concentration of bile in the gallbladder...
July 2016: Il Giornale di Chirurgia
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