Surgery for cystic tumors of pancreas: Report of high-volume, multicenter Indian experience over a decade
| Autor: | Puneet Dhar, Senthilnathan Palaniswamy, Anand Narayan Singh, Manish S. Bhandare, S. Jeswanth, Ramachandran Narayana Menon, Rebala Pradeep, Sandeep Sabnis, Vikram Chaudhari, Shailesh V. Shrikhande, H. Ramesh, G.V. Rao, Sujoy Pal |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent India 030230 surgery Malignancy Cystadenocarcinoma Mucinous 03 medical and health sciences Young Adult 0302 clinical medicine Pancreatectomy Postoperative Complications Sex Factors Risk Factors medicine Humans Hospital Mortality Prospective Studies Cystadenocarcinoma Child Pancreas Aged Aged 80 and over Intraductal papillary mucinous neoplasm business.industry Incidence Age Factors Perioperative Middle Aged medicine.disease Surgery Tumor Burden Pancreatic Neoplasms Serous fluid medicine.anatomical_structure 030220 oncology & carcinogenesis Adenocarcinoma Female Mucinous cystadenocarcinoma Pancreatic Cyst business Hospitals High-Volume |
| Zdroj: | Surgery. 166(6) |
| ISSN: | 1532-7361 |
| Popis: | Background Pancreatic cystic neoplasms remain uncommon. Although data are accumulating on the incidence of pancreatic cystic neoplasms in the published literature, Indian data on these tumors are sparse. Material and Methods We collated data from prospectively maintained databases of patients operated for cystic tumors of the pancreas from 2007 to 2016 at 7 academic centers across India to gain insights into clinical presentation and outcome of the operative treatment of these tumors. Data were compared with large series across the world to understand the regional differences in this pathology. Results Of the 423 patients, there were 98 (23.2%) serous cystic neoplasms, 128 (30.2%) mucinous neoplasms, 34(8%) intraductal papillary mucinous neoplasms, and 121 (28.6%) solid pseudopapillary epithelial neoplasms managed in these 7 academic centers. Malignancy (adenocarcinoma, malignant intraductal papillary mucinous neoplasms, and mucinous cystadenocarcinoma) was reported in 39 (9.2%) patients. Median age at presentation was 41 years, and the female-to-male ratio was 3.4:1. At presentation, 81% of patients were symptomatic. A total of 66.7% of lesions were located in body and tail region of the pancreas. Median tumor size was 6 cm. Operative resection with curative intent was performed in 405 of these 423 patients. Major morbidity occurred in 12%, and 30-day perioperative mortality was 0.9%. Laparoscopic resections were performed in 18% and spleen-preserving resections were performed in 3% of patients. Conclusion Female preponderance, young age, and a benign nature of most pancreatic cystic neoplasms were observed. Large size of tumors on presentation, fewer intraductal papillary mucinous neoplasm resections, and a much greater incidence of solid pseudopapillary epithelial neoplasms were distinctive of this study. Although the proportion of laparoscopic resections and splenic preservation was less compared with Western centers, the perioperative morbidity and mortality was on par with established standards. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect