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腹腔镜手术在局限性胰腺神经内分泌肿瘤中的作用。

The Role of Laparoscopic Surgery in Localized Pancreatic Neuroendocrine Tumours.

机构信息

Hepato-Pancreato-Biliary Surgery Unit, Miulli Hospital, Acquaviva delle Fonti, Bari, Italy.

Medical Oncology Unit, Miulli Hospital, Acquaviva delle Fonti, Bari, Italy.

出版信息

Curr Treat Options Oncol. 2021 Feb 27;22(4):27. doi: 10.1007/s11864-021-00824-5.

Abstract

Pancreatic neuroendocrine tumours (PNETs) are a rare and heterogeneous group of tumours with various clinical manifestations and biological behaviours. They represent approximately 2-4% of all pancreatic tumours, with an incidence of 2-3 cases per million people. PNETs are classified clinically as non-functional or functional, and pancreatic resection is recommended for lesions greater than 2 cm. The surgical approach can involve "typical" and "atypical" resections depending on the number, size and location of the tumour. Typical resections include pancreaticoduodenectomy, distal pancreatectomy enucleation and, rarely, total pancreatectomy. Atypical resections comprise central pancreatectomies or enucleations. Minimally invasive pancreatic resection has been proven to be technically feasible and safe in high-volume and specialized centres with highly skilled laparoscopic surgeons, with consolidated benefits for patients in the postoperative course. However, open and minimally invasive pancreatic surgery remains to have a high rate of complications; there is no specific technical contraindication to minimally invasive pancreatic surgery, but an appropriate patient selection is crucial to obtain satisfactory clinical and oncological outcomes.

摘要

胰腺神经内分泌肿瘤(PNETs)是一组罕见的异质性肿瘤,具有多种临床表现和生物学行为。它们占所有胰腺肿瘤的 2-4%,发病率为每百万人中有 2-3 例。PNETs 临床上分为无功能或有功能型,对于大于 2cm 的病变建议进行胰腺切除术。手术方法可根据肿瘤的数量、大小和位置进行“典型”和“非典型”切除。典型切除术包括胰十二指肠切除术、胰体尾切除术加肿瘤剜除术,很少情况下进行全胰切除术。非典型切除术包括胰中段切除术或肿瘤剜除术。在高容量和专门中心,由技术精湛的腹腔镜外科医生进行微创胰腺切除术已被证明在技术上是可行且安全的,对患者的术后恢复有明确的获益。然而,开放和微创胰腺手术仍然存在高并发症发生率;微创胰腺手术没有特定的技术禁忌,但适当的患者选择对于获得满意的临床和肿瘤学结果至关重要。

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