| Autor: |
BENASSAI, GIACOMO, QUARTO, GENNARO, SOLIMENO, GIOVANNI, Mosella F, Nunziata G, Mosella G. |
| Přispěvatelé: |
Benassai, Giacomo, Mosella, F, Quarto, Gennaro, Nunziata, G, Solimeno, Giovanni, Mosella, G. |
| Rok vydání: |
2007 |
| Popis: |
Sourcerecord Id Scopus 25299 http://www.joplink.net/prev/200709/58.html Context More minimally invasive techniques are currently available for the surgical oncologist in the optimal staging of biliopancreatic cancer. Age is not a limitation for oncological surgery; tumor stage and co-morbidity define the surgical treatment. The increased age of population is accompanied by an increase of age-related diseases, such a cardiovascular disease, hypertension, arthritis and other malignancies. With the development of endoscopy, laparoscopy, ultrasonography and biopsy equipment, more minimally invasive techniques are currently available for the surgical oncologist to provide a better optimal diagnosis and staging strategy, followed by an appropriate surgical treatment of biliopancreatic cancer. Objective Improvement in the diagnostic and surgical care of elderly cancer patients will have a final impact on disease and overall survival rates of the different types of cancer treatment. Methods We retrospectively reviewed the records of patients between January 2001 and December 2006 who had either a mass in the biliopancreatic area classified as clinically resectable. Tumors were considered to be resectable when there was no evidence of distant extra pancreatic disease or involvement of lymphnodes outside the classics margins of resections. Occlusion or encasement of the superior mesenteric artery or vein, celiac artery or portal vein were used as a criteria for unresectability. Twenty-one patients over 65 and under 75 years (middle age 69) with primary biliopancreatic cancer were submitted to operations for potentially operative resection. In all cases staging laparoscopy was performed just prior to planned open exploration and resection. Results Fifteen patients underwent exploratory celiotomy for potential resection. Two of five patients (40%) with distal cholangiocarcinoma survived at 5 years. Six patients (28.6%) had unresectable disease identified at laparoscopy and were spared an unnecessary laparotomy. Conclusions Laparoscopy may have a role in the staging of patients with biliopancreatic malignancies. Staging laparoscopy should be performed to identify patients with metastasis in whom short term endoscopic palliation is satisfactory. Also in elderly pancreaticoduodenectomy for pancreatic and biliary has been associated with the falling post-operative morbidity and mortality rates and long term survival. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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