J 2018

Surgical treatment of ampullary adenocarcinoma – single center experience and a review of literature

KUNOVSKÝ, Lumír, Zdeněk KALA, Vladimír PROCHÁZKA, Martin POTRUSIL, Milan DASTYCH et. al.

Základní údaje

Originální název

Surgical treatment of ampullary adenocarcinoma – single center experience and a review of literature

Název česky

Chirurgická léčba ampulárního adenokarcinomu – zkušenosti jednoho centra a přehled literatury

Autoři

KUNOVSKÝ, Lumír (203 Česká republika, garant, domácí), Zdeněk KALA (203 Česká republika, domácí), Vladimír PROCHÁZKA (203 Česká republika, domácí), Martin POTRUSIL (203 Česká republika, domácí), Milan DASTYCH (203 Česká republika, domácí), Ivo NOVOTNÝ (203 Česká republika, domácí), Tomáš ANDRAŠINA (703 Slovensko, domácí), Zdeněk PAVLOVSKÝ (203 Česká republika, domácí), Michal EID (203 Česká republika, domácí) a Petr MORAVČÍK (203 Česká republika, domácí)

Vydání

Klinická onkologie, Praha, Ambit Media, 2018, 0862-495X

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30212 Surgery

Stát vydavatele

Česká republika

Utajení

není předmětem státního či obchodního tajemství

Kód RIV

RIV/00216224:14110/18:00102847

Organizační jednotka

Lékařská fakulta

DOI

Klíčová slova anglicky

Adenocarcinoma of the ampulla of Vater; Ampullectomy; Duodenum; Endoscopic resection; Pancreaticoduodenectomy; Surgery

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 2. 5. 2019 13:23, Soňa Böhmová

Anotace

V originále

Background: Adenocarcinomas of ampulla of the Vater are relatively uncommon tumors of the gastrointestinal tract. In premalignant lesions endoscopic treatment predominate. According to some authors even early adenocarcinomas (limited to mucosa) can be solved endoscopically. In malignant lesions affecting deeper layers (including submucosa) surgical therapy is the most important. The article summarises the current view for a surgical treatment of ampullary adenocarcinomas and presents results concerning our group of patients. Materials and Methods: In 2012–2016 a total number of 17 patients underwent resection for a tumor of ampulla of the Vater. Patients underwent standard staging, were presented before a multidisciplinary committee and referred to a surgical treatment. The main measured parameters were the type of surgical procedure, 30-day morbidity and mortality, histopathologic result and subsequent oncologic treatment. The Leeds Pathology Protocol was used to evaluate the specimens after pancreaticoduodenectomy (PD). Results: PD (n = 9) was a more often performed procedure than the transduodenal surgical ampullectomy (TSA) (n = 8). TSA predominated in polymorbid patients. Histological results (n = 17) established adenoma with high-grade dysplasia in 4 patients, the diagnosis of adenocarcinoma was set in 13 patients. Eight patients underwent adjuvant oncologic therapy (2 had adjuvant chemotherapy, 6 had combination of chemoradiotherapy). Conclusion: Premalignant neoplasias of ampulla of the Vater can be mostly solved by endoscopy. If endoscopic resection is not possible surgical therapy is indicated. PD is preferred procedure in the diagnosis of adenocarcinoma. In high-risk and polymorbid patients, with no suspicion for a metastatic lymph nodes, TSA can be considered. Endoscopic ultrasonography is the imaging modality of choice for local staging of ampulla of the Vater and has important role in deciding between endoscopic, local surgical excision (TSA) or radical resection (PD). Our results confirmed rightfulness to perform TSA especially in elderly or polymorbid patients, where in histopathologic specimens evaluation in TSA procedures early T stage and more favorable grading predominated.