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Review of intraoperative parathormone monitoring with the miami criterion: A 25-year experience

World Journal of Surgical Procedures 2016年第1期6卷 1-7页

作者： tanaz m vaghaiwalla Zahra F Khan John I Lew Division of Endocrine Surgery De Witt Daughtry Family Department of Surgery University of Miami Leonard M. Miller School of Medicine

With the development of imaging and localization studies,focused parathyroidectomy with use of intraope-rative parathormone monitoring(IPm)is the mainstay of treatment for primary hyperparathyroidism at many health care centers both nationally and *** parathyroidectomy guided by IPm allows for surgical excision of the offending parathyroid gland through smaller *** miami criterion is a protocol that uses a">50%parathormone(PTH)drop"from either the greatest pre-incision or pre-excision measurement of PTH in a blood sample taken 10 min following resection of hyperfunctioning *** removal of the hyperfunctioning parathyroid gland,a>50%PTH drop at 10 min indicates completion of parathyroidectomy,and predicts operative success at6 *** using the miami criterion has demonstrated equal curative rates of>97%,which is comparable to the traditional bilateral neck *** focused approach,however,is associated with shorter recovery times,improved cosmesis,and lower risk of postoperative hypocalcemia.

关键词： Focused parathyroidectomy Intraoperative parathormone monitoring Primary hyperparathyroidism miami criterion Localization studies

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Surgical treatment of non-functioning pancreatic neuroendocrine tumors:current controversies and challenges

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Journal of Pancreatology 2020年第2期3卷 51-58页

作者： memeh Kelvin O. vaghaiwalla tanaz Keutgen Xavier m. Section of Endocrine Surgery Division of General Surgery and Surgical OncologyDepartment of SurgeryThe University of Chicago MedicineChicagoILUSA

There has been a rising trend in the incidence and prevalence of non-functioning pancreatic neuroendocrine tumors(NFPanNETs).While a significant number of the newly diagnosed NFPanNETs are asymptomatic,a majority of patients will present with liver metastasis(Lm)at the time of *** resection remains the only curative treatment,especially for localized *** a majority of small NFPanNETs are indolent,some are *** heterogeneity in tumor biology presents the surgeon with the unique challenge of determining which patient will benefit from surgery,given the morbidity of pancreatic *** has been a recent push for a more aggressive approach to the care of these patients,given the emergence of data supporting such ***,the risk of over or under treatment has generated immense debate amongst experts in the *** heterogeneity of current practice guidelines and institutional practices around the world is a reflection of the disparate opinion on the management of *** this review,we set out to examine the evidence regarding some of the most controversial and challenging aspects of the surgical treatment of *** evaluate the following questions;should patients with small NFPanNETs≤2 cm in size be resected;should patients with metastatic NFPanNETs undergo surgical debulking,and should there be resection of the primary tumor in the setting of non-resectable metastatic disease?Although there are currently no Level 1 data to answer these questions conclusively,we believe that the current literature supports a more aggressive approach to the management of NFPanNET.

关键词： Carcinoid tumors Enucleation Liver debulking Neuroendocrine cancer Neuroendocrine tumor Pancreatic enucleation Pancreatic tumor PRRT Somatostatin analog

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metastatic well-differentiated pancreatic neuroendocrine tumors to the liver: a narrative review of systemic and surgical management

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Journal of Pancreatology 2021年第2期4卷 82-89页

作者： tanaz vaghaiwalla Kelvin memeh Chih-Yi Liao Xavier m.Keutgen Department of Surgery Division of General SurgeryUniversity of Tennessee Graduate School of MedicineKnoxvilleTN b Department of Surgery Division of Surgical OncologyEndocrine Surgery Research ProgramUniversity of Chicago Medicine Department of medicine Section of Hematology and OncologyUniversity of Chicago MedicineChicagoILUSA

Pancreatic neuroendocrine tumors(PNETs)are a rare group of neoplasms originating from the endocrine *** are classified as functional or non-functional *** are more often diagnosed at a higher stage with distant metastases or advanced locoregional *** majority of individuals with hepatic metastases will ultimately die of liver failure;therefore,the treatment of liver tumor burden is critical to providing a survival *** surgical resection remains the only chance of cure for disease confined to the pancreas or for locoregional disease,the treatment of advanced or metastatic PNETs is more complex and often requires a multimodal *** review focuses on treatment options for well and moderately differentiated PNETs with metastatic disease to the *** include surgery,liver-directed therapies including ablative and intra-arterial therapies,and systemic therapies such as somatostatin analogues,targeted therapies,chemotherapy,and peptide receptor radionuclide *** an individualized treatment strategy requires careful assessment of liver tumor burden and predicted biological *** surgical resection of hepatic metastases secondary to PNET primary tumors is associated with improved survival in multiple retrospective *** goals of treatment for metastatic disease include prolonging overall survival and progression free survival,improving quality of life,and control of symptoms.

关键词： Hepatic cytoreduction metastatic disease Pancreatic neuroendocrine tumor Peptide receptor radionuclide therapy Review

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