Symptomatic change and gastrointestinal quality of life after pancreatectomy

Rashid, Lewis; Velanovich, Vic

doi:10.1111/j.1477-2574.2011.00396.x

Cited by 12 publications

(9 citation statements)

References 20 publications

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“…Authors suppose these results might be associated with preservation of intestinal continuity even after an operation. RAMPS has preserved the duodenum and maintained the intestinal continuity, and the patients who underwent RAMPS could maintain the secretion of duodenal hormones such as secretin or cholecystokinin, and the intrinsic innervations could also control the secretion and motility of small intestine [ 12 13 14 ]. Our results about morbidities suggest RAMPS would be a safe and tolerable procedure as well as the conventional DP.…”

Section: Discussionmentioning

confidence: 99%

Initial experience with radical antegrade modular pancreatosplenectomy in a single institution

et al. 2016

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PurposeRadical antegrade modular pancreatosplenectomy (RAMPS) is expected to be favorable for obtaining the negative tangential margin with oncologic feasibility through the horizontal dissection in a right-to-left fashion for radical lymph node dissections.MethodsFrom January 2007 to February 2015, a total of 30 RAMPS and 19 conventional distal pancreatectomy (DP) cases were enrolled. The demographics, perioperative and survival outcomes were compared according to the type of surgery.ResultsThe mean operative time, blood loss and length of hospital stay were similar between 2 groups. Morbidities were reported in 14 cases of RAMPS (46.7%) and 8 cases of DP (42.1%) (P = 0.777). The rate of negative tangential margin (96.2%) and the number of harvested lymph nodes (mean ± standard deviation, 21.5 ± 8.3) were significantly higher in RAMPS group (P = 0.011, P = 0.003, respectively). In terms of survival outcomes, there was no significant difference in regard to the overall 3-year disease-free survival (DFS; 30.4% in RAMPS vs. 35.0% in DP, P = 0.354) or overall survival (OS; 29.9% vs. 29.4%, P = 0.429) between the 2 groups. After exclusion of cases with nodal invasion, however, the RAMPS group had a longer DFS than the DP group (55.6% vs. 27.3%, P = 0.048) although OS was similar without significant difference (42.4% vs. 27.3%, P = 0.197).ConclusionRAMPS is a safe and oncologically feasible procedure in left-sided pancreatic cancer by obtaining a successful negative tangential margin and radical lymph node dissection. The authors suggest it could also be useful for local control, especially for the limited left-sided pancreatic cancer without nodal invasion.

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Section: Discussionmentioning

confidence: 99%

Initial experience with radical antegrade modular pancreatosplenectomy in a single institution

et al. 2016

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“…The first two categories indicate severe and moderate symptoms. The GSRS has been validated for use in a wide variety of gastrointestinal disorders [ 12 – 15 ]. Patients indicated the frequency of bowel movements and stool consistency using a Bristol stool chart with 1 = hard stool and 7 = liquid stool [ 16 ].…”

Section: Methodsmentioning

confidence: 99%

A proposed tailored investigational algorithm for women treated for gynaecological cancer with long-term gastrointestinal consequences

Muls

Taylor

Lalondrelle

et al. 2020

Support Care Cancer

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Background and aim Long-term changes in gastrointestinal function impacting quality of life after treatment for cancer are common. Peer reviewed guidance to investigate and manage GI dysfunction following cancer treatment has been published. This study reviewed gastrointestinal symptoms of women previously treated for gynaecological cancer and considered whether suggested algorithms could be amended to optimise management for this cohort. Methods Demographic and clinical data recorded for patients attending a specialist consequences of cancer treatment gastroenterology service prospectively are reported using median and range. The Wilcoxon signed rank test analysed changes in symptoms between initial assessment to discharge from the service. Results Between April 2013 and March 2016, 220 women, with a median age of 57 years (range 24-83 years), treated for gynaecological cancer (cervical (50%)), endometrial (28%), ovarian (15%), vaginal or vulval (7%) attended. Twelve gastrointestinal symptoms were statistically significantly reduced by time of discharge from the specialist gastroenterology clinic including bowel frequency ≥ 4/day (88%), type 6 or 7 stool consistency (36%), urgency (31%) and incontinence (21%). General quality of life improved from a median score of 4 at first assessment to a median of 6 at discharge (p < 0.001). A median of four (range, 1-9) diagnoses were made. Conclusion Women with gastrointestinal symptoms after cancer treatment benefit from a systematic management approach. After excluding disease recurrence, a proposed investigational algorithm and the oncology team includes FBC, U&Es, LFTs, thyroid function test, vitamin B 12 , vitamin D, a hydrogen methane breath test and a SeHCAT scan. If rectal bleeding is present, iron studies, flexible sigmoidoscopy or colonoscopy should be performed. Patients with normal investigations or symptoms not responding to treatment require gastroenterology input.

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“…43 Furthermore, the Gastrointestinal Symptom Rating Scale has been used to assess GI symptoms after pancreatectomy. 44 These scores can then be used to estimate a quality multiplier (QM), which then can be used to estimate the quality adjusted life years (QALY's) of a patient after resection. These QALY's can then be used to compare treatment options and costeffectiveness.…”

Section: Quality Of Life Considerations For Miprmentioning

confidence: 99%

Minimally invasive pancreatic resections: cost and value perspectives

Conlon

Rooij²,

Hilst³

et al. 2017

HPB

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Challenges remain as to how the potential benefits, both to the patient and the healthcare system as a whole, are measured. Research comparing MIPR versus other techniques for pancreatectomy will require appropriate and valid measurement tools, some of which are yet to be refined. Nonetheless, the experience to date would support the continued development of MIPR by experienced surgeons in high-volume pancreatic centers, married with appropriate review and recalibration.

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Symptomatic change and gastrointestinal quality of life after pancreatectomy

Cited by 12 publications

References 20 publications

Initial experience with radical antegrade modular pancreatosplenectomy in a single institution

Initial experience with radical antegrade modular pancreatosplenectomy in a single institution

A proposed tailored investigational algorithm for women treated for gynaecological cancer with long-term gastrointestinal consequences

Minimally invasive pancreatic resections: cost and value perspectives

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