| 1. |
- Ansari, Daniel, et al.
(författare)
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Safety of pancreatic resection in the elderly : a retrospective analysis of 556 patients
- 2016
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Ingår i: Annals of Gastroenterology. - : Hellenic Society of Gastroenterology. - 1108-7471 .- 1792-7463. ; 29:2, s. 5-221
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The safety of pancreatic resection for elderly patients is still controversial. We examined the postoperative morbidity and mortality in patients aged 75 years or more undergoing pancreatic resection.METHODS: Patients undergoing pancreatic resection were studied retrospectively and the outcomes were compared between patients aged <75 and ≥75 years.RESULTS: Of the 556 patients enrolled, 78 (14%) were ≥75 years old. Elderly patients had significantly more co-morbidities, especially cardiovascular pathology (P=0.005). Also, elderly patients had significantly lower body mass index prior to surgery (P=0.005). There were no significant differences in terms of surgical procedures and tumor types between age groups. The incidence of postoperative pancreatic fistula grade A was significantly lower in the elderly group (P=0.022), but no significant differences were noted in the overall morbidity or the incidence of postpancreatectomy hemorrhage, delayed gastric emptying, bile leakage, cardiac complications, pulmonary complications or septic complications. The 30-day mortality rate was similar between groups (0.8% vs. 1.3%; P=0.532).CONCLUSION: Pancreatic resection is a safe option for selected elderly patients. Our study confirms that age alone should not preclude potentially curative surgical therapy.
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| 2. |
- Byrling, Johannes, et al.
(författare)
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Outcome and evaluation of prognostic factors after pancreaticoduodenectomy for distal cholangiocarcinoma
- 2017
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Ingår i: Annals of Gastroenterology. - : Hellenic Society of Gastroenterology. - 1108-7471 .- 1792-7463. ; 30:5, s. 571-577
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Tidskriftsartikel (refereegranskat)abstract
- Background The aim of the present study was to examine the outcomes and prognostic factors after surgery with curative intent for distal cholangiocarcinoma during a modern timespan, in a Swedish tertiary referral center. Methods All patients who underwent pancreaticoduodenectomy for distal cholangiocarcinoma between April 2008 and December 2015 were identified. Survival was estimated using the Kaplan-Meier analysis. Demographic, clinical, laboratory and histopathological data were evaluated for prognostic factors relating to mortality, using univariable and multivariable statistical analysis. Results Fifty-four patients were included. The mean age was 68±8 years and 21 (39%) of the patients were female. Jaundice was present at diagnosis in 73% of the patients. There was no 90-day mortality. Complications graded as Clavien-Dindo ≥3 occurred in 10 (19%) of the patients. Twenty-eight (52%) received adjuvant therapy. Overall survival rates at 1, 3, and 5 years were 80%, 21%, and 9.2%, respectively. Median survival was 22.2 months. The presence of lymph node metastases was found to be the only independent predictor of survival (hazard ratio 2.88, 95% confidence interval 1.22-6.84; P=0.016). The total number of lymph node metastases, lymph node ratio or total number of resected nodes did not improve the prediction. Conclusions We found that the recurrence rate was higher and the survival poorer after surgery for distal cholangiocarcinoma than has previously been reported. Lymph node status at the time of resection was the most important prognostic factor for survival in the current material.
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| 3. |
- Gundewar, Chinmay, et al.
(författare)
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Antiproliferative effects of curcumin analog L49H37 in pancreatic stellate cells: a comparative study.
- 2015
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Ingår i: Annals of Gastroenterology. - 1108-7471. ; 28:3, s. 391-398
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Tidskriftsartikel (refereegranskat)abstract
- Pancreatic cancer is a devastating disease with poor prognosis. It is characterized by a pronounced stromal reaction, which resists chemotherapeutics and effective tumor treatment. Pancreatic stellate cells (PSCs) are mainly responsible for this stromal reaction. Moreover, the cancer and stromal interaction seems to promote tumor proliferation. In this study, L49H37, a newly synthesized curcumin analog, was used as intervention to target the stromal compartment of pancreatic cancer.
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| 4. |
- Kartalis, Nikolaos, et al.
(författare)
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Recent developments in imaging of pancreatic neuroendocrine tumors
- 2015
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Ingår i: Annals of Gastroenterology. - 1108-7471 .- 1792-7463. ; 28:2, s. 193-202
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Tidskriftsartikel (refereegranskat)abstract
- Pancreatic neuroendocrine tumors (PNETs) are very rare, accounting for 1-2% of all pancreatic neoplasms. They are classified into functioning and non-functioning and their behavior varies widely from benign to highly malignant. For their investigation, a variety of anatomical and functional imaging methods are available. Anatomical methods include computed tomography (CT), magnetic resonance imaging, and ultrasonography. Functional methods include scintigraphy and positron emission tomography (PET). A combination of anatomical and morphological methods results in the so-called hybrid imaging, such as PET/CT. We herein discuss the currently available imaging modalities for the investigation of PNETs and, more specifically, their applications in tumor detection and staging as well as in choice of therapy, imaging follow up and prediction of response, with emphasis on the recent developments.
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| 5. |
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| 6. |
- Koulaouzidis, Anastasios, et al.
(författare)
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Macroscopic findings in collagenous colitis : A multi-center, retrospective, observational cohort study
- 2017
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Ingår i: Annals of Gastroenterology. - : Hellenic Society of Gastroenterology. - 1108-7471 .- 1792-7463. ; 30:3, s. 309-314
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Tidskriftsartikel (refereegranskat)abstract
- Background Collagenous colitis (CC) is by definition a histological diagnosis. However, colonoscopy often reveals characteristic endoscopic findings. The aim of this study was to evaluate the frequency and type of endoscopic findings in patients diagnosed with CC in 4 participating centers. Methods This was a retrospective study; the databases of 2 university hospitals in Edinburgh (Scotland) and Malmö (Sweden), and 2 district general hospitals in Tomelloso (Spain) and Gateshead (England) were interrogated for patients diagnosed with CC between May 2008 and August 2013. Endoscopy reports and images were retrieved and reviewed; data on lesions, sedation, bowel preparation and endoscopist experience were abstracted. Categorical data are reported as mean±SD. Fischer’s exact, chi-square and t (unpaired) tests were used to compare datasets. A two-tailed P-value of <0.05 was considered statistically significant. Results 607 patients (149 male, mean age 66.9±12.25 years) were diagnosed with CC. A total of 108/607 (17.8%) patients had one or more suggestive endoscopy findings: i.e., mucosal erythema/edema, 91/607 (15%); linear colonic mucosal defects, 12/607 (2%); or mucosal scarring, 5/607 (0.82%). For colonic mucosa erythema, there was no difference in the odds of finding erythema with the use of different bowel preparation methods (P=0.997). For colonic mucosal defects there was some evidence (P=0.005) that patients colonoscoped by experienced endoscopists had 87% less odds of developing such defects. Moreover, there was evidence that analgesia reduced the odds of developing mucosal defects by 84%. Conclusion A significant minority of patients with CC have endoscopic findings in colonoscopy. The description of such findings appears to be related to the endoscopist’s experience.
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| 7. |
- Spelt, Lidewij, et al.
(författare)
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Parenchyma-sparing hepatectomy (PSH) versus non-PSH for bilobar liver metastases of colorectal cancer
- 2018
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Ingår i: Annals of Gastroenterology. - : Hellenic Society of Gastroenterology. - 1108-7471 .- 1792-7463. ; 31:1, s. 115-120
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Tidskriftsartikel (refereegranskat)abstract
- Background Preoperative interventions have increased the resectability of colorectal cancer (CRC) liver metastases. This retrospective study compares outcomes after liver resection for bilobar CRC metastases between patients who underwent parenchyma-sparing hepatectomy (PSH), i.e., segmentectomies and smaller resections on both lobes, and those treated with non-PSH, i.e., hemihepatectomy plus any resection on the other lobe. Methods A cohort of 119 patients who underwent liver resection for bilobar CRC metastases were included. Perioperative course and long-term survival were compared between 59 patients who underwent PSH and 60 patients who underwent non-PSH. Statistical analyses were done using Pearson’s chi-square test, Fisher’s exact test and the Mann-Whitney U test. Overall survival analysis was performed by the Kaplan-Meier estimator and Cox regression analysis. Results The median number of liver metastases was 2 in patients treated with PSH and 3 in those treated with non-PSH (P<0.01). Postoperative mortality, severe complications and radicality did not differ significantly between groups. Median intraoperative bleeding was 250 mL for PSH and 600 mL for non-PSH (P<0.001). Median operation time and hospital stay were significantly shorter for PSH. Overall survival was comparable between groups, also after adjustment for covariates. Conclusions There were no significant differences in outcome, except for differences in bleeding, operation time and postoperative stay, favoring PSH. Furthermore, minimizing resection did not influence radicality. Hence, this study supports the use of PSH for bilobar CRC liver metastases when possible.
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