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  1. Artikel: Tumour Heterogeneity and the Consequent Practical Challenges in the Management of Gastroenteropancreatic Neuroendocrine Neoplasms.

    Reccia, Isabella / Pai, Madhava / Kumar, Jayant / Spalding, Duncan / Frilling, Andrea

    Cancers

    2023  Band 15, Heft 6

    Abstract: Tumour heterogeneity is a common phenomenon in neuroendocrine neoplasms (NENs) and a significant cause of treatment failure and disease progression. Genetic and epigenetic instability, along with proliferation of cancer stem cells and alterations in the ... ...

    Abstract Tumour heterogeneity is a common phenomenon in neuroendocrine neoplasms (NENs) and a significant cause of treatment failure and disease progression. Genetic and epigenetic instability, along with proliferation of cancer stem cells and alterations in the tumour microenvironment, manifest as intra-tumoural variability in tumour biology in primary tumours and metastases. This may change over time, especially under selective pressure during treatment. The gastroenteropancreatic (GEP) tract is the most common site for NENs, and their diagnosis and treatment depends on the specific characteristics of the disease, in particular proliferation activity, expression of somatostatin receptors and grading. Somatostatin receptor expression has a major role in the diagnosis and treatment of GEP-NENs, while Ki-67 is also a valuable prognostic marker. Intra- and inter-tumour heterogeneity in GEP-NENS, however, may lead to inaccurate assessment of the disease and affect the reliability of the available diagnostic, prognostic and predictive tests. In this review, we summarise the current available evidence of the impact of tumour heterogeneity on tumour diagnosis and treatment of GEP-NENs. Understanding and accurately measuring tumour heterogeneity could better inform clinical decision making in NENs.
    Sprache Englisch
    Erscheinungsdatum 2023-03-20
    Erscheinungsland Switzerland
    Dokumenttyp Journal Article ; Review
    ZDB-ID 2527080-1
    ISSN 2072-6694
    ISSN 2072-6694
    DOI 10.3390/cancers15061861
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  2. Artikel: The Impact of COVID-19 Global Pandemic on Morbidity and Mortality of Liver Transplant Recipients Children and Adults: A Systematic Review of Case Series.

    Gavriilidis, Paschalis / Pai, Madhava

    Journal of clinical medicine research

    2020  Band 12, Heft 7, Seite(n) 404–408

    Abstract: The pandemic of coronavirus disease 2019 (COVID-19) changed the surgical everyday practice overnight. Currently, the first articles reporting outcomes of liver transplant recipients infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ...

    Abstract The pandemic of coronavirus disease 2019 (COVID-19) changed the surgical everyday practice overnight. Currently, the first articles reporting outcomes of liver transplant recipients infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are published. The aim of the present study was to summarise the existing evidence of impact of COVID-19 global pandemic on liver transplant recipients. Electronic databases were searched in accordance with Preferred Reporting Items in Systematic Reviews and Meta-Analyses (PRISMA). Five studies were selected from a pool of 12 studies with a total of 854 liver transplant recipients of whom 700 were children and the rest 154 were adults. The present evidence, based on case reports and series demonstrated lower mortality in liver transplant recipients compared to general population.
    Schlagwörter covid19
    Sprache Englisch
    Erscheinungsdatum 2020-06-25
    Erscheinungsland Canada
    Dokumenttyp Journal Article ; Review
    ZDB-ID 2548987-2
    ISSN 1918-3011 ; 1918-3003
    ISSN (online) 1918-3011
    ISSN 1918-3003
    DOI 10.14740/jocmr4223
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  3. Artikel ; Online: Single stage management of suspected gallbladder cancer guided by intraoperative frozen section analysis: A retrospective cohort study.

    Banh, Serena / Fehervari, Matyas / Flod, Sara / Soleimani-Nouri, Payam / Leyte Golpe, Antonio / Ahmad, Raida / Pai, Madhava / Spalding, Duncan R C

    International journal of surgery (London, England)

    2024  

    Abstract: Background: The management of radiologically suspected gallbladder cancers (GBC) that lack definitive radiological features usually involves performing a first-stage routine laparoscopic cholecystectomy, followed by an open second-stage liver resection ( ...

    Abstract Background: The management of radiologically suspected gallbladder cancers (GBC) that lack definitive radiological features usually involves performing a first-stage routine laparoscopic cholecystectomy, followed by an open second-stage liver resection (segments IVB and V) and hilar lymphadenectomy (extended cholecystectomy) if subsequent formal histology confirms a malignancy. Performing a cholecystectomy with an intraoperative frozen section to guide the need for conversion to an extended cholecystectomy as a single-stage procedure has multiple benefits compared to a two-stage approach. However, the safety and efficacy of this approach have not yet been evaluated in a tertiary setting.
    Methods: A retrospective cohort study was performed using a database of all consecutive patients with suspected GBC who had been referred to our tertiary unit. Following routine cholecystectomy, depending on the operative findings, the gallbladder specimen was removed and sent for frozen-section analysis. If malignancy was confirmed, the depth of tumour invasion was evaluated, followed by simultaneous extended cholecystectomy, when appropriate. The sensitivity and specificity of frozen section analysis for the diagnosis of GBC were measured using formal histopathology as a reference standard.
    Results: A total of 37 consecutive cholecystectomies were performed. In nine cases, GBC was confirmed by intraoperative frozen section analysis, three of which had standard cholecystectomy only as their frozen section showed adenocarcinoma to be T1a or below (n=2) or were undetermined (n=1). In the remaining six cases, malignant invasion beyond the muscularis propria (T1b or above) was confirmed; thus, a synchronous extended cholecystectomy was performed. The sensitivity (95% CI 66.4%-100%) and specificity (95% CI 87.7%-100%) for identifying GBC using frozen section analysis were both 100%. The net cost of the single-stage pathway in comparison to the two-stage pathway resulted in overall savings of £3894.
    Conclusion: Intraoperative frozen section analysis is a reliable tool for guiding the use of a safe, single-stage approach for the management of GBC in radiologically equivocal cases. In addition to its lower costs compared to a conventional two-stage procedure, intraoperative analysis also affords the benefit of a single hospital admission and single administration of general anaesthesia, thus greatly enhancing the patient's experience and relieving the burden on waiting lists.
    Sprache Englisch
    Erscheinungsdatum 2024-05-03
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 2212038-5
    ISSN 1743-9159 ; 1743-9191
    ISSN (online) 1743-9159
    ISSN 1743-9191
    DOI 10.1097/JS9.0000000000001456
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  4. Artikel: The Impact of COVID-19 Global Pandemic on Morbidity and Mortality of Liver Transplant Recipients Children and Adults: A Systematic Review of Case Series

    Gavriilidis, Paschalis / Pai, Madhava

    Journal of clinical medicine research

    Abstract: The pandemic of coronavirus disease 2019 (COVID-19) changed the surgical everyday practice overnight Currently, the first articles reporting outcomes of liver transplant recipients infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ... ...

    Abstract The pandemic of coronavirus disease 2019 (COVID-19) changed the surgical everyday practice overnight Currently, the first articles reporting outcomes of liver transplant recipients infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are published The aim of the present study was to summarise the existing evidence of impact of COVID-19 global pandemic on liver transplant recipients Electronic databases were searched in accordance with Preferred Reporting Items in Systematic Reviews and Meta-Analyses (PRISMA) Five studies were selected from a pool of 12 studies with a total of 854 liver transplant recipients of whom 700 were children and the rest 154 were adults The present evidence, based on case reports and series demonstrated lower mortality in liver transplant recipients compared to general population
    Schlagwörter covid19
    Verlag WHO
    Dokumenttyp Artikel
    Anmerkung WHO #Covidence: #642997
    Datenquelle COVID19

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  5. Artikel ; Online: HOW TO PERFORM LAPAROSCOPIC DISTAL PANCREATECTOMY USING THE CLOCKWISE TECHNIQUE.

    Costa, Adriano Carneiro da / Spalding, Duncan / Cunha-Filho, Geraldo de Almeida / Santana, Matheus Belem / Pai, Madhava / Jiao, Long R / Habib, Nagy

    Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery

    2022  Band 35, Seite(n) e1683

    Abstract: Background: Laparoscopic pancreatectomy is currently a widely used approach for benign and malignant lesions of the pancreas.: Aims: This study aimed to describe how to perform a laparoscopic distal pancreatectomy using The Clockwise Technique.: ... ...

    Abstract Background: Laparoscopic pancreatectomy is currently a widely used approach for benign and malignant lesions of the pancreas.
    Aims: This study aimed to describe how to perform a laparoscopic distal pancreatectomy using The Clockwise Technique.
    Methods: An 18-year-old female patient presented with a well-defined tumor in the pancreatic body with 4 cm in diameter that suggested a diagnosis of solid pseudopapillary tumor (Frantz's tumor). The patient was recommended for laparoscopic distal pancreatectomy by using The Clockwise Technique.
    Results: The clockwise, caudal-to-cephalic approach appears to have other significant technical advantages that facilitate the performance of the procedure.
    Conclusions: A laparoscopic distal pancreatectomy performed using The Clockwise Technique provides satisfactory outcomes.
    Mesh-Begriff(e) Adolescent ; Female ; Humans ; Laparoscopy/methods ; Pancreas/pathology ; Pancreatectomy/methods ; Pancreatic Neoplasms/pathology
    Sprache Englisch
    Erscheinungsdatum 2022-09-16
    Erscheinungsland Brazil
    Dokumenttyp Case Reports ; Journal Article
    ISSN 2317-6326
    ISSN (online) 2317-6326
    DOI 10.1590/0102-672020220002e1683
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  6. Artikel ; Online: Efficacy of local anaesthetic infiltration via wound catheters after open hepatic surgery: a systematic review and meta-analysis.

    Sadik, Hatem / Watson, Naomi / Dilaver, Nafi / Reccia, Isabella / Cuell, James / Pai, Madhava / Sutcliffe, Robert P / Baharlo, Behrad

    HPB : the official journal of the International Hepato Pancreato Biliary Association

    2022  Band 25, Heft 1, Seite(n) 1–13

    Abstract: Background: This study analysed whether local anaesthetic wound catheter infiltration (LA-WCI) as an adjunct to intravenous patient-controlled analgesia (IV-PCA) provides superior outcomes compared to IV-PCA alone following liver resection.: Methods: ...

    Abstract Background: This study analysed whether local anaesthetic wound catheter infiltration (LA-WCI) as an adjunct to intravenous patient-controlled analgesia (IV-PCA) provides superior outcomes compared to IV-PCA alone following liver resection.
    Methods: A systematic review and meta-analysis was conducted for randomised control trials (RCTs) comparing LA-WCI with IV-PCA(LA-WCI group) versus IV-PCA alone (IV-PCA group). PubMed and the Cochrane Library were searched for relevant articles.
    Results: Six RCTs with a total of 440 patients were included. Opioid use in the initial 48 h was less in the LA-WCI group [MD -21.27 mg (-39.39,-3.15), p = 0.02]. Pain scores were lower in the LA-WCI group at rest at POD0 (post-operative day 0)6-8 h (p = 0.0009), POD1AM(p = 0.01), POD1PM(p = 0.02) and POD2 (p = 0.0006), and exertion at POD0 0-2 h (p = 0.05), POD1AM(p = 0.03), POD1PM(p = 0.03), POD2 (p = 0.03) and POD3 (p = 0.01). LA-WCI group had reduced length of hospital stay [MD -1.32 days (-2.23,-0.40),p = 0.005], time to ambulation [MD -5.94 h (-8.47,-3.42),p = 0.00001] and incidence of nausea and vomiting (PONV) [OR 0.17 (0.07,0.43),p = 0.0002]. No differences were observed in length of intensive care unit (ICU) stay or incidence of surgical site infections.
    Discussion: LA-WCI as an adjunct to opiate IV-PCA post-hepatectomy reduces opioid use, pain scores at multiple time points at rest and exertion, length of hospital stay, time to ambulation and PONV. However, LA-WCI use does not alter length of ICU stay or incidence of wound infection.
    Mesh-Begriff(e) Humans ; Anesthetics, Local/adverse effects ; Analgesics, Opioid/therapeutic use ; Pain, Postoperative/diagnosis ; Pain, Postoperative/etiology ; Pain, Postoperative/prevention & control ; Postoperative Nausea and Vomiting/complications ; Catheters/adverse effects ; Liver/surgery
    Chemische Substanzen Anesthetics, Local ; Analgesics, Opioid
    Sprache Englisch
    Erscheinungsdatum 2022-10-17
    Erscheinungsland England
    Dokumenttyp Meta-Analysis ; Systematic Review ; Journal Article ; Review
    ZDB-ID 2131251-5
    ISSN 1477-2574 ; 1365-182X
    ISSN (online) 1477-2574
    ISSN 1365-182X
    DOI 10.1016/j.hpb.2022.10.006
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  7. Artikel ; Online: Pancreaticoduodenectomy with right hemicolectomy for advanced malignancy: a single UK hepatopancreaticobiliary centre experience.

    Das, Bibek / Fehervari, Matyas / Hamrang-Yousefi, Sahar / Jiao, Long R / Pai, Madhava / Jenkins, John T / Spalding, Duncan R C

    Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

    2022  Band 25, Heft 1, Seite(n) 16–23

    Abstract: Aim: Locally advanced intestinal neoplasms including colon cancer may require radical en bloc pancreaticoduodenectomy and right hemicolectomy (PD-RC) to achieve curative, margin-negative resection, but the safety and benefit of this uncommon procedure ... ...

    Abstract Aim: Locally advanced intestinal neoplasms including colon cancer may require radical en bloc pancreaticoduodenectomy and right hemicolectomy (PD-RC) to achieve curative, margin-negative resection, but the safety and benefit of this uncommon procedure has not been established. The Association of Coloproctology of Great Britain and Ireland IMPACT initiative has also highlighted a lack of awareness about current services available within the UK for patients with advanced colorectal cancer and concerns about low-volume centres managing complex cases. Thus, we aimed to review the feasibility, safety and long-term outcomes of this procedure at a single high-volume hepatopancreaticobiliary surgery unit in the UK.
    Method: A retrospective cohort study was performed using a database of all consecutive patients with intestinal cancer who had been referred to our regional advanced multidisciplinary team and undergone PD-RC in a 7-year period (2013-2020). Clinico-pathological and outcome data were reviewed.
    Results: Ten patients (mean age 54 ± 13, 8/10 men) were identified. Final histology revealed the primary tumour sites were colon (n = 7) and duodenum (n = 3). R0 resection was achieved in all cases. The major complication rate (Clavien-Dindo ≥ 3) was 10% (1/10) with no deaths within 90 days of surgery. The Kaplan-Meier estimated 5-year overall survival was 83.3% (95% CI 58.3%-100%). Univariate survival analysis identified perineural invasion and extra-colonic origin as predictors of poor survival (log-rank P < 0.05).
    Conclusion: En bloc PD-RC for locally advanced intestinal cancer can be performed safely with a high proportion of margin-negative resections and resultant long-term survival in carefully selected patients.
    Mesh-Begriff(e) Male ; Humans ; Pancreaticoduodenectomy/methods ; Retrospective Studies ; Colonic Neoplasms/pathology ; Colorectal Neoplasms/surgery ; Colectomy/methods
    Sprache Englisch
    Erscheinungsdatum 2022-09-01
    Erscheinungsland England
    Dokumenttyp Journal Article
    ZDB-ID 1440017-0
    ISSN 1463-1318 ; 1462-8910
    ISSN (online) 1463-1318
    ISSN 1462-8910
    DOI 10.1111/codi.16303
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  8. Artikel ; Online: A systematic review into patient reported outcomes following pancreaticoduodenectomy for malignancy.

    Patel, Bhavik Y / White, Laura / Gavriilidis, Paschalis / Satyadas, Thomas / Frampton, Adam E / Pai, Madhava

    European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

    2020  Band 47, Heft 5, Seite(n) 970–978

    Abstract: Background: Pancreaticoduodenectomy is associated with high rates of morbidity. This combined with the psychological burden of cancer, may impact on a patient's quality of life (QoL), which can be measured by using patient-reported outcomes (PRO).: ... ...

    Abstract Background: Pancreaticoduodenectomy is associated with high rates of morbidity. This combined with the psychological burden of cancer, may impact on a patient's quality of life (QoL), which can be measured by using patient-reported outcomes (PRO).
    Objective: To perform a systematic review to evaluate the measurement of PRO after pancreaticoduodenectomy for cancer.
    Methods: 7 different databases were searched using 2 groups of search terms, one relating to pancreaticoduodenectomy, and one to PRO. Three authors screened the search results independently in a systematic manner based on predefined inclusion and exclusion criteria.
    Results: 27 studies, with 2173 eligible patients were included in the final analysis. Most of the included studies used validated instruments. The European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire was most popular and used in 12 studies. The methodology of all included studies was also scrutinised. 12 studies were deemed to have high quality methodology according to pre-defined criteria.
    Conclusion: The instruments and methods used to measure PRO are variable. The quality of PRO within the available literature has improved over time, as has the number of studies measuring PRO. PRO should be measured with uniformity in future trials so that patients can be provided with more comprehensive information regarding post-operative recovery and QoL during the shared decision-making process preoperatively.
    Mesh-Begriff(e) Humans ; Pancreatic Neoplasms/psychology ; Pancreatic Neoplasms/surgery ; Pancreaticoduodenectomy ; Patient Reported Outcome Measures ; Quality of Life
    Sprache Englisch
    Erscheinungsdatum 2020-12-08
    Erscheinungsland England
    Dokumenttyp Journal Article ; Systematic Review
    ZDB-ID 632519-1
    ISSN 1532-2157 ; 0748-7983
    ISSN (online) 1532-2157
    ISSN 0748-7983
    DOI 10.1016/j.ejso.2020.11.146
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  9. Artikel ; Online: Integrating the evidence for single-incision laparoscopic cholecystectomy: is it "looking" good?

    Pai, Madhava / Frampton, Adam E / Jiao, Long R

    Annals of surgery

    2015  Band 261, Heft 3, Seite(n) e85–7

    Mesh-Begriff(e) Bile Ducts/injuries ; Cholecystectomy, Laparoscopic/adverse effects ; Cholecystectomy, Laparoscopic/methods ; Female ; Humans ; Intraoperative Complications/epidemiology ; Male
    Sprache Englisch
    Erscheinungsdatum 2015-03
    Erscheinungsland United States
    Dokumenttyp Comment ; Letter
    ZDB-ID 340-2
    ISSN 1528-1140 ; 0003-4932
    ISSN (online) 1528-1140
    ISSN 0003-4932
    DOI 10.1097/SLA.0000000000000210
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  10. Artikel: Effectiveness of Terlipressin on Modulation of Portal Vein Pressure after Hepatic Resections in Non-Cirrhotic Patients. A Systematic Review and Meta-Analysis of Randomised Controlled Trials.

    Gavriilidis, Paschalis / Roberts, Keith J / Angelis, Nicola de / Memeo, Riccardo / Pai, Madhava / Saverio, Salomone Di / Askari, Alan / Sutcliffe, Robert P

    Chirurgia (Bucharest, Romania : 1990)

    2020  Band 115, Heft 6, Seite(n) 707–714

    Abstract: Background-Objectives: It has been reported, that high posthepatectomy portal vein pressure (PVP) has deleterious effect on the liver parenchyma and causes posthepatectomy liver failure (PHLF) and increased 90-day mortality. Terlipressin, is widely used ... ...

    Abstract Background-Objectives: It has been reported, that high posthepatectomy portal vein pressure (PVP) has deleterious effect on the liver parenchyma and causes posthepatectomy liver failure (PHLF) and increased 90-day mortality. Terlipressin, is widely used to mitigate the effects of portal hyper-tension. Randomised clinical trials (RCTs) demonstrated encouraging results of use of terlipressin for modulation of increased posthepatectomy PVP. The aim of the present study was to evaluate the effectiveness of the pharmacological modulation of the increased posthepatectomy PVP after major hepatectomy.
    Mesh-Begriff(e) Cardiovascular Agents/pharmacology ; Hepatectomy/adverse effects ; Humans ; Liver Cirrhosis/surgery ; Liver Diseases/surgery ; Portal Pressure/drug effects ; Portal Vein/drug effects ; Portal Vein/surgery ; Randomized Controlled Trials as Topic ; Terlipressin/pharmacology ; Treatment Outcome
    Chemische Substanzen Cardiovascular Agents ; Terlipressin (7Z5X49W53P)
    Sprache Englisch
    Erscheinungsdatum 2020-12-30
    Erscheinungsland Romania
    Dokumenttyp Journal Article ; Meta-Analysis ; Systematic Review
    ZDB-ID 419244-8
    ISSN 1842-368X ; 1221-9118 ; 0009-4730 ; 0377-5003
    ISSN (online) 1842-368X
    ISSN 1221-9118 ; 0009-4730 ; 0377-5003
    DOI 10.21614/chirurgia.115.6.707
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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