二十年来,胰岛素瘤的诊断和手术治疗的变化
D Wiese1, F G Humburg2, P H Kann3
1Department of Visceral, Thoracic and Vascular Surgery, Philipps University, Marburg, Germany. wiesed@med.uni-marburg.de.
Langenbeck's archives of surgery
|June 29, 2023
概括
在过去的二十年中,改进的成像和外科手术技术改善了胰岛素瘤的诊断和治疗. 对大多数胰岛素瘤患者来说,现在可以实现微创手术和高治愈率.
科学领域:
- 内分泌学 在内分泌学.
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
背景情况:
- 胰岛素瘤是一种罕见的胰腺神经内分泌瘤 (NETs).
- 胰岛素瘤的诊断和手术治疗已经显著发展.
- 进展旨在改善局部化和治疗结果.
研究的目的:
- 在20年 (2000-2020年) 期间,分析胰岛素瘤患者的诊断和手术管理的变化.
- 评估改进的成像和外科手术技术对患者结果的影响.
主要方法:
- 对经过手术的,经过组织学证明的胰岛素瘤患者的前性数据库的回顾性分析.
- 患者被分为两组:2000-2010年 (第一组) 和2011-2020年 (第二组).
- 临床病理特征,诊断方式,手术方法和结果在各组之间进行了比较.
主要成果:
- 内镜超声波 (EUS) 在胰岛素瘤局部化方面表现出高灵敏度 (89%在组1,100%在组2).
- 最少侵入性的手术方法显著增加,从1组的19%增加到2组的50% (p=0.022).
- 良性胰岛素瘤的术后并发症率和长期治愈率仍然很好 (100%).
结论:
- 胰岛素瘤的手术前定位在现代成像技术,特别是EUS中非常成功.
- 在选定的患者中,微创性,护体内膜节省切除是可行的.
- 胰岛素瘤治疗提供了优秀的长期治愈率.
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