1,721,458 research outputs found
Resection for pancreatic cancer with arterial involvement: A paradigm shift away from unresectable to “how to do it”
No full textDuring the past 30 years, pancreatic surgery has evolved considerably. Honestly, I would not have anticipated many of these changes, but luckily enough, they have occurred and have improved the management and the prognosis of patients with pancreatic cancer. Some of these changes have been truly groundbreaking, such as the advent of minimally invasive distal and now even proximal pancreatectomies, the availability of effective medical therapies, and the improved definition of prognostic factors. In keeping with some of these changes, some centers have begun to extend their indications for pancreatic resections to arterial involvement. The value of these extended procedures, however, remains controversial
Author response to: Comment on: Bioethical approach to robot-assisted surgery in the era of shared decision making
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2021 SSAT Debate: Selective Approach to Resection of the Superior Mesenteric Artery in Pancreatic Cancer vs Superior Mesenteric Artery Encasement Is Not an Absolute Contraindication for Surgery in Pancreatic Cancer
No full textThis manuscript summarizes an excellent debate from the 2021 SSAT/Pancreas Club symposium on arterial resection in pancreas cancer. Two world-recognized experts, Professor Ugo Boggi from Pisa, IT, and Dr. Mark Truty from the Mayo Clinic in Rochester, MN, offered their views on the role of arterial resection in locally advanced pancreas ductal adenocarcinoma. Both speakers have extensive experience pushing the technical envelope with extended vascular resection in pancreatectomy. However, both highlight important concepts of resectability extending well beyond technique: namely, patient global physiology, tumor biology, and response to chemotherapy. The debate was spirited, and this subsequent review is an excellent look at the status quo. N. J. Zyromski, MD, Indianpolis, IN, November, 2021
Pancreas transplantation
No full textPURPOSE OF REVIEW: To define recent changes and future directions in the practice of pancreas transplantation (PT). Two major events have occurred in the past 18 months: COVID-19 pandemic, and the first world consensus conference on PT. Several innovative studies were published after the consensus conference. RECENT FINDINGS: During COVID-19 pandemic PT activity decreased. COVID-19 in transplant recipients increases mortality rates, but data from kidney transplantation show that mortality might be higher in waitlisted patients.The world consensus conference provided 49 jury deliberations on the impact of PT on management of diabetic patients and 110 practice recommendations.Recent evidence demonstrates that PT alone is safe and effective, that results of simultaneous pancreas and kidney (SPK) remain excellent despite older recipient age and higher prevalence of type 2 diabetes, that use of hepatitis C virus (HCV)-positive donors into HCV-negative recipients is associated with good outcomes, and that use of sirolimus as primary immunosuppressant and costimulation blockade does not improve results of SPK. SUMMARY: COVID-19 pandemic and the first world consensus conference on PT were major events. Although COVID-19 pandemic should not reduce PT activity in the future, a major positive impact on both volume and outcomes of PT is awaited from the proceedings of the world consensus conference
Computer-Aided Altruistic Unbalanced Paired Kidney Exchanges Based on Virtual Crossmatching and Predicted Post-Transplant Creatinine Clearance
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