European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
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Comparative Study
Outcomes and patterns of secondary relapse in platinum-sensitive ovarian cancer: implications for tertiary cytoreductive surgery.
To evaluate the outcomes and patterns of patients with secondary relapsed ovarian cancer. ⋯ Limited survival benefit from tertiary cytoreductive surgery was observed in patients with platinum-sensitive secondary relapsed ovarian cancer.
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Comparative Study
Colorectal liver metastases: hepatic pedicle clamping during hepatectomy reduces the incidence of tumor recurrence in selected patients. Case-matched analysis.
Hepatic pedicle clamping (HPC) during Liver Resection (LR) is a vascular procedure designed to prevent bleeding from the liver during hepatectomy. Outgrowth of pre-existing colorectal micrometastases may occur 5-6 times faster in occluded liver lobes than in non-occluded lobes. We conducted a case-matched analysis at our Institution to assess the effects of HPC on overall and recurrence-free survival in highly selected patients, who underwent LR due to Colorectal liver metastases (CLM). ⋯ A case-matched study was performed in 120 patients undergoing liver resection due to colorectal liver metastases, comparing patients who received intermittent hepatic pedicle clamping (HPC) with those who did not. The 5-year overall survival rate was similar, but the 5-year recurrence-free rate was significantly higher with no HPC (p = 0.012).
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Meta Analysis
Patients get more long-term benefit from central pancreatectomy than distal resection: a meta-analysis.
Central pancreatectomy (CP) protects more normal pancreatic parenchyma than distal pancreatectomy (DP), but the safety, feasibility and long-term benefit of CP are inconclusive. This meta-analysis aims to ascertain the relative merits of CP. ⋯ CP was still an acceptable and feasible procedure, especially when considering the postoperative pancreatic function preservation ability by CP.
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Postoperative care for major elective cancer surgery is frequently provided on the Intensive Care Unit (ICU). ⋯ Elective cancer surgery represents a significant part of all ICU admissions, with a short length of stay and low mortality.
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Comparative Study
Placement of an arterial hepatic catheter after a major hepatectomy for colorectal liver metastases: is this safe?
Studies have suggested that hepatic arterial infusion of chemotherapy (HAI) after resection of colorectal liver metastasis (CRLM) may improve patient's survival. The placement of a catheter in the hepatic artery at the time of hepatic surgery should therefore be considered in patients at high risk of hepatic recurrence. The aim of this study was to compare post-operative outcomes in patients who underwent at least a major hepatectomy (≥3 segments) for CRLM with or without catheter placement. ⋯ Although the placement of an arterial catheter during a major hepatectomy does not significantly increase the rate of postoperative complications two patients died post-operatively in this study from vascular thrombosis. In case of extended and complex hepatectomy, with a higher risk of post-operative complications, delaying the catheter placement could be recommended.