Clinical degree of the superior mesenteric vein involvement with the surgery in the pancreas uncinate process carcinoma / 中华外科杂志

<p><b>OBJECTIVE</b>To create the clinical degree of the superior mesenteric vein (SMV) involvement in pancreas uncinate process carcinoma (PUPC) and its clinical significance to be discussed.</p><p><b>METHODS</b>According to the contiguous relationship between the SMV and the PUPC, the clinical degree of SMV involvement in PUPC are as followings four grades, 1 grade, the grade of clear boundary. 2 grade, the grade of fuzzy boundary. 3 grade, the grade of dissolved boundary. 4 grade, the grade of SMV infringed. The coherence between the type under the CT scan (Tx) and the type under the inoperative judgement (Sx) were analyzed with Kappa-test.</p><p><b>RESULTS</b>There is a significant difference between the grade of SMV involvement and the surgery. The resection rate is 100% in 1st grade, 97.4% in 2nd grade, 65.8% in 3rd grade and 21.7% in 4th grade. There is coherent in the degree judgement between the CT scan and the inoperative inspection (U = 15.96, P < 0.01).</p><p><b>CONCLUSIONS</b>There is clinical significance to establish the degree of SMV involvement in PUPC. It is helpful for clinician to accurately know its anatomic characteristic and decide more reasonable surgical strategy.</p>

The surgical treatment of the solid-pseudopapillary tumor of pancreas: report of 21 cases / 中华外科杂志

<p><b>OBJECTIVE</b>The surgical therapies and prognoses on 21 solid-pseudopapillary tumors (SPT) of pancreas were summarized in our center.</p><p><b>METHODS</b>Twenty-one SPTs were retrospectively studied and divided into two groups, the complete capsular group and the incomplete one. The analyses were performed by SAS6.12 Stat. software.</p><p><b>RESULTS</b>There are no tumor recurrences in all patients. There are significant difference between operative types in radical resection and the tumor position of the pancreas (P = 0.038). There are also significant differences between the capsular integrity and the course of the diseases (P = 0.029), and the possible malignant cells by the frozen section examination (P = 0.001), and the size of the tumor (P = 0.0004). The judgement on the capsular integrity of the tumor could directly effect the adoptable operative types (P = 0.001).</p><p><b>CONCLUSIONS</b>The surgical resection is good treatment for the SPT, which has satisfying prognosis.</p>

Clinical misdiagnosis of solid pseudopapillary tumour of pancreas / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Since being reclassified by WHO in 1996, solid pseudopapillary tumour (SPT) of pancreas has been recognized as the internationally accepted name. Clinicians are lacking in knowledge of this rare disease so the misdiagnosis and inappropriate therapy are hard to avoid. The clinic data on 22 patients were summarized to study the misdiagnosis and treatment of a sample of SPTs.</p><p><b>METHODS</b>Twenty-two female patients with SPT were studied retrospectively and divided into two groups, the misdiagnosed group and the correctly diagnosed one. The analyses were performed with Fisher test with accurate probability for categorical data, and Kruskal-Wallis test for ranked data.</p><p><b>RESULTS</b>The rate of misdiagnosis in this sample was 45.5%. The misdiagnosed SPTs were apt to be the incomplete capsule ones (P = 0.020), which resulted in obvious difficulties during operation (P = 0.024). In the misdiagnosed SPT group, the medical expenses increased significantly (P = 0.042), and the number of days in hospital greater than in correctly diagnosed group (P = 0.041).</p><p><b>CONCLUSIONS</b>Although SPT has low malignancy with excellent prognosis after surgical treatment in most patients, the misdiagnosis of SPT increases the social and economic burdens on patients. It is important to analyse the causes of misdiagnosis.</p>