Surgery for Small Intestine Neuroendocrine Tumors: Mesenteric Dissection Requires NET-Specific Skill скачать в хорошем качестве

Surgery for Small Intestine Neuroendocrine Tumors: Mesenteric Dissection Requires NET-Specific Skill

Surgical management of small intestine neuroendocrine (carcinoid) tumors requires a special skill set. Uniquely, many patients with small intestine neuroendocrine tumors have a mesenteric mass, a ball of hard tissue, surrounding the blood supply. In addition, the disease spreads to lymph nodes extending to the origin of the superior mesenteric vessels, which supply the blood to the small intestines. Meticulous dissection is required to safely and completely remove the mesenteric mass and lymph nodes while not injuring the blood supply. Surgical management of small intestine neuroendocrine tumors Treatment of small intestine neuroendocrine neoplasms Surgery for small intestine neuroendocrine cancers Art of surgery for small intestine neuroendocrine tumors Surgery 101 for small intestine NETs Diagnosis and treatment of small intestinal NETs Overview of small intestine neuroendocrine neoplasms Yogo A, Paciorek A, Kasai Y, Moon F, Hirose K, Corvera CU, Bergsland EK, Nakakura EK. Long-Term Survival Outcomes After Minimally Invasive Surgery for Ileal Neuroendocrine Tumors. Ann Surg Oncol. 2024 Sep;31(9):5507-5514. doi: 10.1245/s10434-024-15468-6. Epub 2024 May 26. PMID: 38797790; PMCID: PMC11300575. Mahuron KM, Kasai Y, Javeed ZA, Bergsland EK, Hirose K, Corvera CU, Nakakura EK. Minimally Invasive Surgery for Ileal Neuroendocrine Tumors. J Gastrointest Surg. 2021 Nov;25(11):2954-2956. doi: 10.1007/s11605-021-04974-7. Epub 2021 Mar 19. PMID: 33742361. Nakakura EK. Challenges Staging Neuroendocrine Tumors of the Pancreas, Jejunum and Ileum, and Appendix. Ann Surg Oncol. 2018 Mar;25(3):591-593. doi: 10.1245/s10434-017-6026-9. Epub 2017 Aug 4. PMID: 28779367. Bergsland EK, Nakakura EK. Neuroendocrine tumors of unknown primary: is the primary site really not known? JAMA Surg. 2014 Sep;149(9):889-90. doi: 10.1001/jamasurg.2014.216. PMID: 25029597. Wang SC, Parekh JR, Zuraek MB, Venook AP, Bergsland EK, Warren RS, Nakakura EK. Identification of unknown primary tumors in patients with neuroendocrine liver metastases. Arch Surg. 2010 Mar;145(3):276-80. doi: 10.1001/archsurg.2010.10. PMID: 20231629. Unlike other cancers, small intestine neuroendocrine tumors form a mesenteric mass and spread to nearby lymph nodes. Overtime, they spread to deep lymph nodes surrounding the blood supply to the small intestines. Special training and surgical skill are necessary to safely remove the mesenteric mass and lymph nodes to avoid injury to the blood vessels. It is important to leave as much healthy intestine behind, so patients can eat and maintain a good quality of life. The primary tumors, nearby lymph nodes, and mesenteric mass are removed. Deeper lymph nodes are carefully peeled off the blood vessels. If left behind, the disease will eventually surround the blood vessels and safe surgery to remove them may no longer be possible. With progressive scaring, or fibrosis, the blood supply to the intestines may become compromised. See a team of NET specialists to ensure NET-specific surgery is done when indicated.