Acta Chirurgica Belgica最新文献

Tranexamic acid in patients undergoing burn surgery: an updated meta-analysis. 烧伤手术患者的氨甲环酸：一项最新的荟萃分析。

IF 0.8 4区医学

Acta Chirurgica Belgica Pub Date : 2025-09-08 DOI: 10.1080/00015458.2025.2557015

Jianzhen Shi, Jianru Xu, Yanmei Chen, Siyu Sun

{"title":"Tranexamic acid in patients undergoing burn surgery: an updated meta-analysis.","authors":"Jianzhen Shi, Jianru Xu, Yanmei Chen, Siyu Sun","doi":"10.1080/00015458.2025.2557015","DOIUrl":"10.1080/00015458.2025.2557015","url":null,"abstract":"Background: Surgical procedures often entail significant blood loss, potentially leading to various complications. Thus, reducing perioperative bleeding is crucial to enhancing patient outcomes. This study systematically evaluates and conducts a meta-analysis on the efficacy of tranexamic acid (TXA) in patients undergoing burn surgery.Methods: A comprehensive literature search was performed across PubMed, the Cochrane Central Register of Controlled Trials, Embase, and Web of Science databases to identify pertinent clinical studies on the application of TXA in burn-related surgical procedures. The evaluated outcomes included total blood loss, postoperative hemoglobin levels, postoperative hematocrit, intraoperative packed red blood cell (PRBC) transfusion units, incidence of intraoperative transfusion, and duration of hospitalization.Results: The analysis incorporated seven studies with a total of 427 patients. Compared to the control group, TXA was associated with a significant reduction in total blood loss [MD = -152.17 mL (95% CI: -159.48 to -144.87)], total PRBC units transfused [MD = -0.61 units (95% CI: -0.92 to -0.30)], and intraoperative transfusion incidence [logRR = -0.70 (95% CI: -1.04 to -0.35)]. However, there were no significant differences observed in postoperative hemoglobin levels [MD = 0.47 g/dL (95% CI: -0.12 to 1.06)], postoperative hematocrit [MD = 2.13% (95% CI: -0.66 to 4.92)], or length of hospital stay [MD = -2.80 days (95% CI: -6.44 to 0.83)].Conclusions: TXA appears to effectively reduce blood loss and the requirement for PRBC transfusions in burn surgery. Further high-quality research is necessary to substantiate these findings.Abbreviations: TXA: tranexamic acid; PRBC: packed red blood cell; MD: mean difference; REML: restricted maximum likelihood; logOR: log odds ratio.","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-9"},"PeriodicalIF":0.8,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144999484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hemorrhagic shock secondary to pre-existing adrenal myelolipoma: a case report and review of the literature. 先前存在的肾上腺骨髓瘤继发失血性休克1例报告及文献复习。

IF 0.8 4区医学

Acta Chirurgica Belgica Pub Date : 2025-09-04 DOI: 10.1080/00015458.2025.2556992

Delphine Keppens, Sam Van Slycke, Klaas Van Den Heede

{"title":"Hemorrhagic shock secondary to pre-existing adrenal myelolipoma: a case report and review of the literature.","authors":"Delphine Keppens, Sam Van Slycke, Klaas Van Den Heede","doi":"10.1080/00015458.2025.2556992","DOIUrl":"10.1080/00015458.2025.2556992","url":null,"abstract":"Background: Adrenal myelolipomas are benign tumors composed of mature adipose tissue and hematopoietic elements, such as myeloid and erythroid cells. They are often asymptomatic and do not require treatment unless complications arise.Methods: A case description and brief review of the literature is performed.Results: This case report outlines the hospital course and management of a 77-year-old woman who was admitted to the emergency department with hemorrhagic shock after a traumatic fall. A full body computed tomography (CT) scan revealed a voluminous mass in the right adrenal gland with an active hemorrhage in the right hypochondrium. After reviewing her medical records, it became clear that the hemorrhage arose from a pre-existing adrenal myelolipoma, discovered nine years earlier. Additionally, she sustained multiple fractures including right-sided rib fractures, a compression fracture of L1, and a complex fracture of the right scapula, accompanied by a significant hematoma. The clinical approach included initial stabilization, embolization procedures to control the hemorrhage, and comprehensive follow-up care.Conclusion: This case illustrates that timely recognition and management of traumatic hemorrhage from pre-existing masses, such as an adrenal myelolipoma, are crucial for improving patient outcomes and minimizing complications such as hypovolemic shock.","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-4"},"PeriodicalIF":0.8,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

8-Years' experience of the interventional and non-interventional treatment of pancreatic and peripancreatic necrosis in patients with severe acute pancreatitis secondary to gallstones and alcohol abuse. A single centre analysis. 8年胆结石合并酒精滥用的严重急性胰腺炎继发性胰腺及胰周坏死的介入及非介入治疗经验单中心分析。

IF 0.8 4区医学

Acta Chirurgica Belgica Pub Date : 2025-09-03 DOI: 10.1080/00015458.2025.2554882

Davide Di Mauro, Alex Reece-Smith, Ikechukwu Njere, Shahjehan Wajed, Antonio Manzelli

{"title":"8-Years' experience of the interventional and non-interventional treatment of pancreatic and peripancreatic necrosis in patients with severe acute pancreatitis secondary to gallstones and alcohol abuse. A single centre analysis.","authors":"Davide Di Mauro, Alex Reece-Smith, Ikechukwu Njere, Shahjehan Wajed, Antonio Manzelli","doi":"10.1080/00015458.2025.2554882","DOIUrl":"10.1080/00015458.2025.2554882","url":null,"abstract":"Background: The treatment of acute pancreatitis (AP) with pancreatic and peripancreatic necrosis (PN and PPN) can be challenging. It is unclear why some patients respond to conservative management while others require an invasive treatment. This study aimed to assess the clinical and radiological characteristics of patients with gallstone or alcohol-induced AP with PN and PPN who underwent interventional or non-interventional treatment.Methods: Subjects with gallstone or alcohol-induced AP and radiological evidence of PN and PPN, from 2010 to 2018, were divided in two treatment-based groups: interventional-percutaneous drainage (PD) and/or surgical necrosectomy-and non-interventional. A comparison of clinical and radiological characteristics between groups was conducted.Results: Of 99 patients, 18 underwent interventional treatment, 81 conservative management. The interventional group had larger PN (p = 0.010) and a greater proportion of infected necrosis (p = 0.002). Acute necrotic collection (ANC) >10 cm (95% CI 1.26-3.6, OR 1.839, p = 0.012), infected necrosis (95% CI 4.28-61305.6, OR 153.9, p = 0.026), admission to the intensive care unit (ICU) (95% CI 16.79-326,532.21, OR 489.915, p = 0.007), were predictors of interventions. Patients who underwent PD only had up to four drains inserted and 16.7% hospital mortality; subjects who underwent surgery had up to two drains and 33.3% death rate.Conclusions: Most subjects with severe gallstone and alcohol-related AP were treated medically. Large ANC, infected necrosis, and ICU admission predicted the need for intervention. When an invasive treatment was required, PD alone was effective with a tendency towards repeated drain insertions.","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-10"},"PeriodicalIF":0.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Breast surgery in Greece during 19th century. The example of professor Theodoros Aretaios (1829-1893). 19世纪希腊的乳房手术。以Theodoros Aretaios教授（1829-1893）为例。

IF 0.8 4区医学

Acta Chirurgica Belgica Pub Date : 2025-08-29 DOI: 10.1080/00015458.2025.2553510

Konstantinos Laios, Constantinos G Zografos, Pavlos Lytsikas-Sarlis, Evangelia Mourellou, Irina Noskova, Tsoucalas Gregory, Georgios Androutsos

{"title":"Breast surgery in Greece during 19th century. The example of professor Theodoros Aretaios (1829-1893).","authors":"Konstantinos Laios, Constantinos G Zografos, Pavlos Lytsikas-Sarlis, Evangelia Mourellou, Irina Noskova, Tsoucalas Gregory, Georgios Androutsos","doi":"10.1080/00015458.2025.2553510","DOIUrl":"https://doi.org/10.1080/00015458.2025.2553510","url":null,"abstract":"Background: Professor Theodoros Aretaios (1829-1893) was the most prominent figure in Greek Surgery during nineteenth century. Apart from other operations he performed, he focused also on breast surgery.Methods: Theodoros Aretaios was a prolific writer. He wrote two main textbooks in Greek. The one is a surgical atlas and the other a surgical pathology textbook. Apart from them he left a great archive of the patient he operated on. Most of them refer to breast surgery and will be highlighted by our study.Results: Except two male patients all the others were women in Theodoros Aretaios' archive, and the vast majority suffered from breast cancer. Benign disease of the breast although more common were mentioned concisely. Theodoros Aretaios performed total or partial mastectomy, lymphadenectomy and he underlined that the excision of the thoracic muscles or even the ribs had nothing to offer apart from aggravating patient's condition allowing us today to understand his pioneering role in the medical thought of his time.Conclusion: Theodoros Aretaios patient archive about breast diseases is the first systematic review of such patients in Greece, after the creation of the modern Greek State. The great variety of information shows the very high level of theoretical knowledge in breast surgery, which can be also seen by the surgical approach to benign and malignant disease.","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-7"},"PeriodicalIF":0.8,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

An early report of using protecting gloves by Ḥakim Mohammad, a Persian surgeon (16th century CE). 波斯外科医生Ḥakim Mohammad（公元16世纪）关于使用防护手套的早期报告。

IF 0.8 4区医学

Acta Chirurgica Belgica Pub Date : 2025-08-01 Epub Date: 2025-04-08 DOI: 10.1080/00015458.2025.2489802

Narges Tajik, Zahra Ghahremani, Sobhan Ghezloo, Shahrzad Irannejad, Arman Zargaran

引用次数: 0

Cervico-thoracic paraganglioma associated with Horner's syndrome: a case report. 颈胸副神经节瘤合并霍纳综合征1例。

IF 0.8 4区医学

Acta Chirurgica Belgica Pub Date : 2025-08-01 Epub Date: 2025-06-09 DOI: 10.1080/00015458.2025.2512488

Naïla El Nakadi, Jâd Abi-Khalil, Sarah Landenne, Isabelle De Quin, Jean Lemaitre

{"title":"Cervico-thoracic paraganglioma associated with Horner's syndrome: a case report.","authors":"Naïla El Nakadi, Jâd Abi-Khalil, Sarah Landenne, Isabelle De Quin, Jean Lemaitre","doi":"10.1080/00015458.2025.2512488","DOIUrl":"10.1080/00015458.2025.2512488","url":null,"abstract":"Background: Cervico-thoracic paragangliomas are rare hypervascular neuroendocrine tumors, with high morbidity and mortality due to locally invasive growth. They are often misdiagnosed in patients with cervical masses. Horner's syndrome, in this case, results from a lesion of the stellate ganglion. Only a few cases in the literature describe paragangliomas affecting the stellate ganglion.Case report: We report the case of a 61-year-old female with a cervico-thoracic paraganglioma associated with Horner's syndrome. She had no significant medical history. Cervical computed tomography (CT) and magnetic resonance imaging (MRI) revealed a large, highly vascularized antero-superior mediastinal mass measuring 6.8 cm x 5 cm x 9 cm, surrounding the left subclavian and carotid arteries, and slightly compressing the trachea, esophagus, and innominate vein. Surgery provided the definitive diagnosis through histopathological analysis. We highlight the different types of paragangliomas and the challenges in diagnosis. A 2-year follow-up with CT and PET-CT scans confirmed no recurrence of the lesion.Conclusions: Paragangliomas are rare, slow-growing neuroendocrine tumors that may appear wherever autonomic ganglia are present. Clinical presentations vary, including lesions of the stellate ganglion causing ipsilateral Horner's syndrome. Paragangliomas should be considered in the differential diagnosis of cervico-thoracic masses. Treatment involves complete surgical resection while preserving neurovascular structures.","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"211-214"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A prospective diagnostic accuracy study of the Alvarado score in a Croatian hospital - is it time for a final conclusion? 克罗地亚一家医院对阿尔瓦拉多评分的前瞻性诊断准确性研究——是得出最终结论的时候了吗？

IF 0.8 4区医学

Acta Chirurgica Belgica Pub Date : 2025-08-01 Epub Date: 2025-06-03 DOI: 10.1080/00015458.2025.2512279

Branko Bakula, Ante Bogut, Andrija Karačić, Maja Bakula, Antonio Marić, Vanja Radišić Biljak

{"title":"A prospective diagnostic accuracy study of the Alvarado score in a Croatian hospital - is it time for a final conclusion?","authors":"Branko Bakula, Ante Bogut, Andrija Karačić, Maja Bakula, Antonio Marić, Vanja Radišić Biljak","doi":"10.1080/00015458.2025.2512279","DOIUrl":"10.1080/00015458.2025.2512279","url":null,"abstract":"Background: The diagnosis of acute appendicitis (AA) still represents a considerable problem for surgeons, with a relatively high rate of false positive findings still present. Thus, the aim of our study was to evaluate the diagnostic accuracy of the Alvarado scoring system based on the prospectively included subjects who presented to the emergency department with suspected AA.Methods: From June 2018 to May 2020, 176 adult patients examined in the Emergency surgical department of University Hospital Sveti Duh with suspicion of AA were prospectively included in the study. The decision on the need for surgery in all patients was made by the same surgeon based only on clinical judgment and remained independent of any diagnostic scoring system.Results: Fifty-eight (33.0%) of them were operated with negative appendectomy rate of 17.2%. Results showed that the surgeon's decision-making process is superior to the Alvarado scoring system (sensitivity and specificity were 96 and 92.06% vs. 84 and 87.30%, respectively).Conclusion: The Alvarado scoring system proved to be a worse predictor of the diagnosis of AA compared to the assessment of an experienced surgeon and is not an adequate diagnostic tool for confirming the diagnosis. Only in a narrow group of patients in whom, based on the clinical examination, an indication for surgery has already been established, the Alvarado scoring system can potentially be useful in excluding the diagnosis with considerable caution in terms of close follow-up of the patient.Abbreviations: MSCT: multislice computed tomography; AA: acute appendicitis.","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"197-201"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Surgical training; destination unknown? A survey on surgical employment in Flanders. 外科培训；去向不明？

IF 0.8 4区医学

Acta Chirurgica Belgica Pub Date : 2025-08-01 Epub Date: 2025-04-29 DOI: 10.1080/00015458.2024.2391176

Niels Komen, Marian Vanhoeij, Paul De Leyn, Frederik Berrevoet, Piet Pattyn, Guy Hubens

{"title":"Surgical training; destination unknown? A survey on surgical employment in Flanders.","authors":"Niels Komen, Marian Vanhoeij, Paul De Leyn, Frederik Berrevoet, Piet Pattyn, Guy Hubens","doi":"10.1080/00015458.2024.2391176","DOIUrl":"10.1080/00015458.2024.2391176","url":null,"abstract":"Background: A surgical fellowship allows both additional training as well as maintenance of surgical skills while searching for a steady job. As the presence of fellows usually does not result in a measurably higher productivity, fellowships may be considered a form of disguised unemployment. The aim of this study is to evaluate the career flow of a surgical trainee to a staff position and to determine the number of surgeons working on temporary basis within the general surgery workforce in Flanders.Methods: All surgeons graduated in Flanders between 2000 and 2022 were invited to fill out a web-based survey concerning their current and past employment. Reminders were sent out after 2 and 4 weeks. Statistical analysis was performed with SPSS version 27.0 (IBM Inc., Chicago, IL).Results: Response rate was 64% (292/457) with 76% of respondents currently working as surgeons, 14% (38) as fellows and 10% working outside the surgical domain. Eighty-two percent of current fellows graduated in 2019 or later. Thirty-one percent of surgeons graduated in 2019 are still working as fellows. For surgeons graduated in 2020, 2021 and 2022, this is 45%, 80% and 90%, respectively. Compared to staff surgeons, the number of additional training years (2.8 ± 1.0 vs. 2.2 ± 1.3; p = .009) and the number of applications (6.6 ± 5 vs. 3.3 ± 3; p < .001) are significantly higher for current fellows.Conclusion: This study shows that disguised unemployment is present in the general surgical community in Flanders. The status of 'fellow' should be incorporated in calculations concerning future needs of the surgical workforce in order to prevent open unemployment.","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"177-182"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141905506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Surgical management of pseudomyxoma peritonei: low-volume center experience. 腹膜假性黏液瘤的外科治疗：小容积中心经验。

IF 0.8 4区医学

Acta Chirurgica Belgica Pub Date : 2025-08-01 Epub Date: 2025-05-26 DOI: 10.1080/00015458.2025.2510121

Charif Khaled, Lina Safar, Alain Hendlisz, Maria Gomez Galdon, Paulus Kristanto, Michel Moreau, Ana Veron Sanchez, Gabriel Liberale

{"title":"Surgical management of pseudomyxoma peritonei: low-volume center experience.","authors":"Charif Khaled, Lina Safar, Alain Hendlisz, Maria Gomez Galdon, Paulus Kristanto, Michel Moreau, Ana Veron Sanchez, Gabriel Liberale","doi":"10.1080/00015458.2025.2510121","DOIUrl":"10.1080/00015458.2025.2510121","url":null,"abstract":"Introduction: Pseudomyxoma peritonei (PMP) is a rare disease characterized by diffuse peritoneal invasion of multifocal mucinous deposits. Gold standard treatment involves cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC). We aimed to compare the outcomes of operated PMP patients in a low-volume center, with those of high-volume centers and using other regimens.Materials and methods: Retrospective analysis was conducted for PMP patients treated by CRS + HIPEC (using the Elias high-dose Oxaliplatin HIPEC regimen) over a 15-year period (January 2007 - December 2021) at the Jules Bordet Institute - H.U.B.Results: 32 patients were included. Pathology results were: 21.9% acellular mucin, 34.4% low-grade, and 43.7% high-grade. The median peritoneal cancer index was 24 (range 3-36). The median follow-up was 58 months. The rate of major complications (Clavien-Dindo III/IV) was 41% and postoperative mortality was 3%. Mean disease-free survival (DFS) was estimated at 40 +/- 4 months (standard deviation (SD)) while overall survival (OS) was 122 +/- 9 months (SD). DFS reached a plateau of 44.5% at 5 and 10 years and OS was 92.3% and 76.2% respectively. Statistical analysis showed low-grade PMP to be predictive of better DFS and OS (p = 0.0111 and p = 0.0293 respectively). We also found that female gender was predictive of better DFS (p = 0.0262).Conclusion: Our postoperative morbidity and mortality rates, DFS, and OS were similar to those reported in the literature for high-volume PMP centers. Our theory is that surgical proficiency can be more attributed to the surgeon's CRS experience, regardless of the nature of the disease.","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"190-196"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Downstaging and R0 resection of initially unresectable metastatic well-differentiated grade-3 pancreatic neuroendocrine tumor: a case report. 最初不可切除的转移性高分化3级胰腺神经内分泌肿瘤的降期和R0切除：1例报告。

IF 0.8 4区医学

Acta Chirurgica Belgica Pub Date : 2025-08-01 Epub Date: 2025-06-06 DOI: 10.1080/00015458.2025.2515325

Arthur Houbiers, Joseph Weerts, Ghislain Houbiers, Roland Materne, Nancy Witvrouw, Noella Blétard, Benoit Monami, Christian Focan, Ivan Borbath

{"title":"Downstaging and R0 resection of initially unresectable metastatic well-differentiated grade-3 pancreatic neuroendocrine tumor: a case report.","authors":"Arthur Houbiers, Joseph Weerts, Ghislain Houbiers, Roland Materne, Nancy Witvrouw, Noella Blétard, Benoit Monami, Christian Focan, Ivan Borbath","doi":"10.1080/00015458.2025.2515325","DOIUrl":"10.1080/00015458.2025.2515325","url":null,"abstract":"Introduction: High-grade pancreatic neuroendocrine tumors are rare, and most of them are well differentiated. Management of this type of tumor is not yet well established.Methods: A 28-year-old woman was referred to our hospital for a well-differentiated grade-3 pancreatic neuroendocrine tumor with multiple liver metastases. The patient received neoadjuvant therapy consisting of combination of Capecitabine/Temozolomide chemotherapy and somatostatin analogue.Results: An excellent regression was observed on both pancreatic and hepatic lesions, and therefore, an aggressive surgical management could be performed with a two-step scheme. Adjuvant hormono-chemotherapy was administered between the two surgeries. The patient achieved six years of disease-free survival following the last therapy.Discussion and conclusion: We highlight the difference between well and poorly differentiated high-grade neuroendocrine neoplasia and report that aggressive surgery is a valid option even in metastatic presentation at diagnosis.","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"215-221"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0