Citations 2
REDISCOVER International Guidelines on the Perioperative Care of Surgical Patients With Borderline-resectable and Locally Advanced Pancreatic Cancer
Boggi, Ugo , Kauffmann, Emanuele F. , Barreto, Savio George , Fusai, Giuseppe , Hackert, Thilo , Hilal, Mohammad Abu , Shrikhande, Shailesh, Truty, Mark J. , Werner, Jens , Wolfgang, Christopher L. , Capretti, Giovanni , Cattelani, Alice , Sio, Davide De , Dato, Armando Di, Meo, Giovanna Di , Gianfaldoni, Cesare , Salinas, C , Montorsi, Roberto Maria , Pagnanelli, Michele , Poli, Andrea , Sucameli, Francesco , Viti, Virginia, Addeo, Pietro , Bachellier, Philippe , Barbarello, Linda, Busquets, Juli , Butturini, Giovanni , Caniglia, Fabio, Chunhua, Xi, Colangelo, Ettore, Coratti, Andrea , Costa, Francesca, Crafa, Francesco , Valle, Raffaele Dalla , Carlis, Luciano De , Chiaro, Marco Del , Domak, Safi, Ercolani, Giorgio , Filauro, Marco, Gruttaduaria, Salvatore, Izbicki, Jakob R. , Jovine, Elio , Kiguchi, Gozo , Kooby, David A. , Lang, Hauke , Lombardo, Carlo , Massani, Marco , Miao, Yi , Mishima, Kohei , Molino, Carlo , Nardo, Bruno , Panaro, Fabrizio , Pasquali, Claudio , Perrone, Vittorio, Rangelova, Elena , Liu, Rong, Romito, Raffaele, Rosso, Edoardo , Schulick, Richard D. , Spampinato, Marcello , Troisi, Roberto , Uzunoglo, Faik G, Veneroni, Luigi , Zerbi, Alessandro , Vicente, Emilio, Vistoli, Fabio , Wakabayashi, Go , Zanus, Giacomo , Zureikat, Amer H., Zyromski, Nicholas J. , Davide, José , Dervenis, Christos, Konlon, Kevin C., Michelassi, Fabrizio, Nealon, William H. , Portolani, Nazario , Silva, Donzília Sousa , Ferrari, Viviana Nicoleta, Cameron, John L., Clavien, Pierre‐Alain , Asbun, Horacio J. , Board, The REDISCOVER Multidisciplinary Advisory, Truty, Mark, Napoli, Niccolò , Besselink, Marc G , Marchegiani, Giovanni , Salvia, Roberto , Bannone, Elisa , Coppola, Alessandro , Cucchetti, Alessandro , Fiorillo, Claudio , Ginesini, Michael , Lai, Quirino , Miccoli, Mario , Ricci, Claudio , Tamburrino, Domenico , Alfieri, Sergio , Baiocchi, Gian Luca , Balzano, Gianpaolo , Brolese, Alberto , Caputo, Damiano D. , Casadei, Riccardo , Wilde, Roeland F. de , Benedetto, Fabrizio Di , Sebastiano, Pierluigi Di , Hogg, Melissa E. , Egorov, V. , Ettorre, Giuseppe M , Falconi, Massimo , Ferrari, Giovanni , Ferrero, Alessandro , Giardino, Alessandro , Grazi, Gian Luca , Gruttadauria, Salvatore , Katz, Matthew H. G. , Keck, Tobias , Khatkov, Igor , Malleo, Giuseppe , Mazzaferro, Vincenzo , Memeo, Riccardo , Nagakawa, Yuichi , Nakamura, Masafumi , Liu, Rong, Romagnoli, Renato , Siriwardena, Ajith K. , Strobel, Oliver , Testini, Mario , Valente, Umberto , Vivarelli, Marco , Coppola, Roberto , D’Andrea, Vito , Frigerio, Isabella M. , Montorsi, Marco , Bozzi, Giuseppe, Ferrari, Viviana, Trivella, Maria Giovanna , Board, The REDISCOVER Multidisciplinary Advisory
Annals of Surgery | February 26, 2024 | Volume: 280 | Issue: 1 | Pages: 56-65
Objective: The REDISCOVER consensus conference aimed at developing and validating guidelines on the perioperative care of patients with borderline-resectable (BR-) and locally advanced (LA) pancreatic ductal adenocarcinoma (PDAC). Background: Coupled with improvements in chemotherapy and radiation, the contemporary approach to pancreatic surgery supports the resection of BR-PDAC and, to a lesser extent, LA-PDAC. Guidelines outlining the selection and perioperative care for these patients are lacking. Methods: The Scottish Intercollegiate Guidelines Network (SIGN) methodology was used to develop the REDISCOVER guidelines and create recommendations. The Delphi approach was used to reach a consensus (agreement ≥80%) among experts. Recommendations were approved after a debate and vote among international experts in pancreatic surgery and pancreatic cancer management. A Validation Committee used the AGREE II-GRS tool to assess the methodological quality of the guidelines. Moreover, an independent multidisciplinary advisory group revised the statements to ensure adherence to nonsurgical guidelines. Results: Overall, 34 recommendations were created targeting centralization, training, staging, patient selection for surgery, possibility of surgery in uncommon scenarios, timing of surgery, avoidance of vascular reconstruction, details of vascular resection/reconstruction, arterial divestment, frozen section histology of perivascular tissue, extent of lymphadenectomy, anticoagulation prophylaxis, and role of minimally invasive surgery. The level of evidence was however low for 29 of 34 clinical questions. Participants agreed that the most conducive means to promptly advance our understanding in this field is to establish an international registry addressing this patient population (https://rediscover.unipi.it/). Conclusions: The REDISCOVER guidelines provide clinical recommendations pertaining to pancreatectomy with vascular resection for patients with BR-PDAC and LA-PDAC, and serve as the basis of a new international registry for this patient population.
The Miami International Evidence-based Guidelines on Minimally Invasive Pancreas Resection
Asbun, Horacio J. , Moekotte, Alma , Vissers, Frederique L., Kunzler, F. , Cipriani, Federica , D’Angelica, Michael I. , Balduzzi, Alberto , Bassi, Claudio , Björnsson, Bergþór , Boggi, Ugo , Callery, Mark P., Chiaro, Marco Del , Coimbra, Felipe José Fernández , Conrad, Claudius , Cook, Andrew , Coppola, Alessandro , Dervenis, Christos, Dokmak, Safi , Edil, Barish H. , Giulianotti, Pier Cristoforo , Hansen, Paul D., Heijde, Nicky van der , Hilst, Jony van , Hester, Caitlin A. , Hogg, Melissa E. , Jarufe, Nicolás , Jeyarajah, D. Rohan, Kim, Song Cheol, Khatkov, Igor , Kokudo, Norihiro , Kooby, David A. , Korrel, Maarten , Leon, Francisco J. de, Lluís, Núria , Lof, Sanne , Demartines, Nicolas , Merchant, Nipun B. , Molenaar, I. Quintus, Moravek, Cassadie, Mou, Yiping , Nealon, William H. , Palanivelu, Chinnusamy, Pessaux, Patrick , Pitt, Henry A. , Primrose, John N., Rawashdeh, Arab , Sanford, Dominic E. , Senthilnathan, Palanisamy, Shrikhande, Shailesh V. , Stauffer, John , Takaori, Kyoichi , Tang, Chung Ngai, Vollmer, Charles M., Wakabayashi, Go , Walsh, R. Matthew , Wang, Shin-E, Zinner, Michael J. , Wolfgang, Christopher L. , Zureikat, Amer H. , Zwart, M. , Conlon, Kevin C. , Kendrick, Michael L., Zeh, Herbert J. , Hilal, Mohammad Abu, Besselink, Marc G. , Primrose, John , Hilal, Mohammad Abu , Demartines, N , A Stauffer, John , Alseidi, Adnan A. , Edwin, Bjørn , Han, Ho-Seong , Jeyarajah, D. Rohan , Keck, Tobias , Machado, Marcel Autran C. , Martinie, John B. , Moravek, Cassadie, Nakamura, Masafumi , Palanivelu, Chinnusamy , Polanco, Patricio Marcelo , Talamonti, Marina , Wang, Shin‐E , Kendrick, Michael L. , Besselink, Marc G , Cipriani, Federica
Annals of Surgery | September 22, 2019 | Volume: 271 | Issue: 1 | Pages: 1-14
Objective: The aim of this study was to develop and externally validate the first evidence-based guidelines on minimally invasive pancreas resection (MIPR) before and during the International Evidence-based Guidelines on Minimally Invasive Pancreas Resection (IG-MIPR) meeting in Miami (March 2019). Summary Background Data: MIPR has seen rapid development in the past decade. Promising outcomes have been reported by early adopters from high-volume centers. Subsequently, multicenter series as well as randomized controlled trials were reported; however, guidelines for clinical practice were lacking. Methods: The Scottisch Intercollegiate Guidelines Network (SIGN) methodology was used, incorporating these 4 items: systematic reviews using PubMed, Embase, and Cochrane databases to answer clinical questions, whenever possible in PICO style, the GRADE approach for assessment of the quality of evidence, the Delphi method for establishing consensus on the developed recommendations, and the AGREE-II instrument for the assessment of guideline quality and external validation. The current guidelines are cosponsored by the International Hepato-Pancreato-Biliary Association, the Americas Hepato-Pancreato-Biliary Association, the Asian-Pacific Hepato-Pancreato-Biliary Association, the European-African Hepato-Pancreato-Biliary Association, the European Association for Endoscopic Surgery, Pancreas Club, the Society of American Gastrointestinal and Endoscopic Surgery, the Society for Surgery of the Alimentary Tract, and the Society of Surgical Oncology. Results: After screening 16,069 titles, 694 studies were reviewed, and 291 were included. The final 28 recommendations covered 6 topics; laparoscopic and robotic distal pancreatectomy, central pancreatectomy, pancreatoduodenectomy, as well as patient selection, training, learning curve, and minimal annual center volume required to obtain optimal outcomes and patient safety. Conclusion: The IG-MIPR using SIGN methodology give guidance to surgeons, hospital administrators, patients, and medical societies on the use and outcome of MIPR as well as the approach to be taken regarding this challenging type of surgery.