Operative Standards for Cancer Surgery: Volume III

 

Description:

The Operative Standards for Cancer Surgery manuals provide evidence-based recommendations for the proper technical conduct of cancer surgery. Presented by the American College of Surgeons, Operative Standards for Cancer Surgery: Sarcoma, Adrenal, Neuroendocrine, Peritoneal Malignancies, Urothelial, Hepatobiliary helps surgeons distill the latest evidence into best practices and techniques that lead to improved outcomes. Focused on the steps between skin incision and skin closure, this manual is an invaluable resource for surgical oncologists and general surgeons alike.

 

 

Table of Contents:

 

SECTION I. SARCOMA

INTRODUCTION

CLINICAL STAGING

MULTIDISCIPLINARY CARE

PERIOPERATIVE CARE

Preoperative Clinical and Imaging Evaluation

Biopsy

Postoperative Care and Follow-up

QUALITY MEASURES

CHAPTER 1: Resection of Extremity and Trunk Soft Tissue Sarcoma

CRITICAL ELEMENTS

1. PRETREATMENT BIOPSY OF SOFT TISSUE MASSES OF THE EXTREMITY AND TRUNK

Rationale

Technical Aspects

2. MACROSCOPICALLY COMPLETE RESECTION OF THE PRIMARY TUMOR

Recommendation

Rationale

En bloc resection of the biopsy tract

Surgical margins

Intraoperative frozen section

Technical Aspects

Management of neurovascular bundles

Management of bone and tendons

Clip placement for postoperative radiation planning

Indications for amputation

Soft tissue reconstruction

Special considerations for specific histologic subtypes

3. PLACEMENT OF SURGICAL DRAINS

Rationale

Technical Aspects

INTRODUCTION

METHODOLOGY

FINDINGS

Incidence of Regional Lymph Node Metastasis

Impact of Sentinel Lymph Node Biopsy on Patient Outcomes

Completion Lymph Node Dissection after Positive Sentinel Lymph Node Biopsy

CONCLUSION

CHAPTER 2: Resection of Retroperitoneal and Intra-Abdominal Soft Tissue Sarcoma

CRITICAL ELEMENTS

1. MACROSCOPICALLY COMPLETE RESECTION OF PRIMARY TUMOR WITHOUT DISRUPTION OF TUMOR CAPSULE

Rationale

Technical Aspects

2. EN BLOC RESECTION OF INVADED ORGANS TO OBTAIN A COMPLETE GROSS RESECTION

Rationale

Technical Aspects

Psoas resection

Management of neurovascular and bony structures

Consideration of specific histologies

Gastrointestinal stromal tumors

Desmoid tumors

INTRODUCTION

METHODOLOGY

FINDINGS

Definition of Extent of Surgical Resection

Impact of Extent of Surgery on Multivisceral Resection

Impact of Extent of Surgery on Local Recurrence

Association between Margins, Extended Resection, Multivisceral Resection, and Local Recurrence

CONCLUSION

Synoptic Operative Report: Extremity Sarcoma

Synoptic Operative Report: Retroperitoneal Sarcoma

COMMENTARY: SARCOMA SECTION

SECTION II. ADRENAL

INTRODUCTION

CLINICAL STAGING

MULTIDISCIPLINARY CARE

PERIOPERATIVE CARE

QUALITY MEASURES

CHAPTER 3: Adrenalectomy Including Multivisceral Resection

CRITICAL ELEMENTS

1. RESECTION OF THE PRIMARY TUMOR TO MICROSCOPICALLY NEGATIVE MARGINS WITHOUT DISRUPTION OF THE TUMOR CAPSULE

Rationale

Technical Aspects

Right adrenalectomy

Left adrenalectomy

2. EN BLOC RESECTION OF ADJACENT ORGANS DIRECTLY INVADED BY CANCER

Rationale

Technical Aspects

INTRODUCTION

METHODOLOGY

FINDINGS

CONCLUSION

CHAPTER 4: Vascular Invasion

CRITICAL ELEMENTS

1. EN BLOC RESECTION OF ADJACENT BLOOD VESSELS DIRECTLY INVOLVED BY PRIMARY TUMOR AND/OR TUMOR THROMBUS

Rationale

Technical Aspects

Exposure of the inferior vena cava

Vascular control

Infrahepatic

Retro- and Suprahepatic but below the Diaphragm

Infracardiac Inferior Vena Cava and Intra-atrial

Extraction of tumor thrombus; resection and reconstruction of the IVC

INTRODUCTION

METHODOLOGY

FINDINGS

CONCLUSION

CHAPTER 5: Lymphadenectomy

CRITICAL ELEMENTS

1. RESECTION OF REGIONAL LYMPH NODES INVOLVED BY METASTATIC ADRENAL CANCER

Rationale

Technical Aspects

INTRODUCTION

METHODOLOGY

FINDINGS

CONCLUSION

Synoptic Operative Report: Adrenal

COMMENTARY: ADRENAL SECTION

SECTION III. NEUROENDOCRINE

INTRODUCTION

Neuroendocrine Tumors

Neuroendocrine Carcinomas

Mixed Tumors

CLINICAL STAGING

MULTIDISCIPLINARY CARE

Carcinoid Syndrome

Locally Advanced and Metastatic Disease

PERIOPERATIVE CARE

QUALITY MEASURES

CHAPTER 6: Small Bowel Resection

CRITICAL ELEMENTS

1. INTRAOPERATIVE EVALUATION AND IDENTIFICATION OF PRIMARY TUMOR(S)

Rationale

Intraoperative exploration for duodenal neuroendocrine tumors/gastrinoma

Intraoperative exploration for jejunal/ileal neuroendocrine tumors

Technical Aspects

Gastrinoma

Jejunal/ileal neuroendocrine tumors

2. REGIONAL LYMPHADENECTOMY ALONG SEGMENTAL VESSELS

Rationale

Technical Aspects

Duodenum

Jejunum and ileum

3. RESECTION OF THE PRIMARY TUMOR

Rationale

Technical Aspects

Duodenum

Jejunum/ileum

INTRODUCTION

METHODOLOGY

FINDINGS

Pathogenesis of Gallstones Secondary to Somatostatin Analogues

Frequency of Gallstone Formation in Patients Treated with Somatostatin Analogues

Prophylactic Cholecystectomy in Patients Treated for Metastatic Neuroendocrine Tumors

CONCLUSION

INTRODUCTION

METHODOLOGY

FINDINGS

CONCLUSION

CHAPTER 7: Parenchyma-Preserving Pancreatectomy

CRITICAL ELEMENTS

1. INTRAOPERATIVE ULTRASOUND PRIOR TO ENUCLEATION

Rationale

Technical Aspects

2. RESECTION OF THE PRIMARY TUMOR

Rationale

Enucleation

Central and spleen-preserving distal pancreatectomy

Technical Aspects

Enucleation

Central and spleen-preserving distal pancreatectomy

3. REGIONAL LYMPH NODE SAMPLING OF THE PERIPANCREATIC AND CELIAC LYMPH NODES

Rationale

Technical Aspects

INTRODUCTION

METHODOLOGY

FINDINGS

Impact of Lymph Node Status on Recurrence-Free Survival

Impact of Lymph Node Status on Overall Survival

CONCLUSION

Synoptic Operative Report: Pancreatic Neuroendocrine Tumor

Synoptic Operative Report: Small Bowel Neuroendocrine Tumor

COMMENTARY: NEUROENDOCRINE SECTION

SECTION IV. PERITONEAL MALIGNANCIES

INTRODUCTION

CLINICAL STAGING

MULTIDISCIPLINARY CARE

PERIOPERATIVE CARE

Patient History and Physical

Tumor Markers

Imaging

Diagnosis

Surgical Management

Postoperative Care

QUALITY MEASURES

CHAPTER 8: Cytoreduction

CRITICAL ELEMENTS

1. SUPRACOLIC GREATER OMENTECTOMY

Rationale

Technical Aspects

Greater omentectomy

Lesser omentectomy

2. RESECTION OF MESENTERIC DISEASE

Rationale

Technical Aspects

Small bowel mesenteric peritonectomy

3. CYTOREDUCTION OF THE DIAPHRAGM

Rationale

Technical Aspects

Subdiaphragmatic peritonectomy

Full-thickness resection of the diaphragm

4. CYTOREDUCTION WITHIN THE PELVIS

Rationale

Technical Aspects

Pelvic peritonectomy

Hysterectomy

Rectosigmoid resection

Operating in the setting of prior hysterectomy

5. ABDOMINAL VISCERAL RESECTIONS

Rationale

Enteric resection

Hepatic resection

Pancreatectomy and/or splenectomy

Technical Aspects

Enteric resection

Liver resection

Visceral peritonectomy of the right upper quadrant

Pancreatectomy and/or splenectomy

CHAPTER 9: Drug Delivery and Safety

CRITICAL ELEMENTS

1. HYPERTHERMIC INTRAPERITONEAL CHEMOTHERAPY FOLLOWING CYTOREDUCTION

Rationale

Open versus closed technique

Technical Aspects

INTRODUCTION

METHODOLOGY

FINDINGS

PCI Limit in PSD Associated with Colorectal Cancer

PCI limit in PSD associated with appendiceal cancer/pseudomyxoma peritonei

PCI limit in PSD associated with gastric cancer

CONCLUSION

INTRODUCTION

METHODOLOGY

FINDINGS

CONCLUSION

Synoptic Operative Report: Peritoneal

COMMENTARY: PERITONEAL SECTION

SECTION V. UROTHELIAL

INTRODUCTION

CLINICAL STAGING

MULTIDISCIPLINARY CARE

PERIOPERATIVE CARE

QUALITY MEASURES

CHAPTER 10: Endoscopic Management

CRITICAL ELEMENTS

1. ENDOSCOPIC EVALUATION OF URETHRA AND BLADDER

Rationale

Technical Aspects

2. TRANSURETHRAL RESECTION OF BLADDER TUMOR

Rationale

Technical Aspects

3. ENDOSCOPIC EVALUATION AND TREATMENT OF UPPER TRACT DISEASE

Rationale

Technical Aspects

4. POSTOPERATIVE INSTILLATION OF INTRAVESICAL CHEMOTHERAPY

Rationale

Technical Aspects

CHAPTER 11: Partial Cystectomy

CRITICAL ELEMENTS

1. INTRAOPERATIVE LOCALIZATION OF TUMOR

Rationale

Technical Aspects

2. RESECTION TO ADEQUATE MARGINS

Rationale

Margin status

Ureteral implantation

Carcinoma in situ

Technical Aspects

CHAPTER 12: Radical Cystectomy

CRITICAL ELEMENTS

1. REMOVAL OF BLADDER TO NEGATIVE RESECTION MARGINS

Rationale

Technical Aspects

2. CONCOMITANT PELVIC ORGAN MANAGEMENT IN MEN AND WOMEN

Rationale

Women

Men

Technical Aspects

Women

Men

3. PELVIC LYMPH NODE DISSECTION

Rationale

Technical Aspects

4. SELECTION OF A URINARY DIVERSION PROCEDURE

Rationale

Technical Aspects

Ileal conduit

Orthotopic diversion

Continent cutaneous diversion

INTRODUCTION

METHODOLOGY

FINDINGS

DISCUSSION

CONCLUSION

INTRODUCTION

METHODOLOGY

FINDINGS

DISCUSSION

CONCLUSION

CHAPTER 13: Nephroureterectomy

CRITICAL ELEMENTS

1. REMOVAL OF KIDNEY AND URETER

Rationale

Circumstances for segmental or distal ureteral resection

Technical Aspects

Considerations

Open nephroureterectomy

Minimally invasive nephroureterectomy

Segmental ureterectomy

2. MANAGEMENT OF THE DISTAL URETER/CUFF

Rationale

Technical Aspects

3. LYMPHADENECTOMY FOR UPPER TRACT UROTHELIAL CANCER DURING DEFINITIVE RESECTION

Rationale

Technical Aspects

4. PERIOPERATIVE INSTILLATION OF INTRAVESICAL CHEMOTHERAPY

Rationale

Technical Aspects

Synoptic Operative Report: TURBT

Synoptic Operative Report: Radical Cystectomy

Synoptic Operative Report: Nephroureterectomy

Synoptic Operative Report: Partial Cystectomy

COMMENTARY: UROTHELIAL CANCER

SECTION VI. HEPATOBILIARY

INTRODUCTION

CLINICAL STAGING

Colorectal Liver Metastases

Hepatocellular Cancer

Perihilar Cholangiocarcinoma

Intrahepatic Cholangiocarcinoma

Gallbladder Cancer

MULTIDISCIPLINARY CARE

Colorectal Liver Metastases

Hepatocellular Cancer

Perihilar Cholangiocarcinoma

Intrahepatic Cholangiocarcinoma

Gallbladder Cancer

PERIOPERATIVE CARE

Preoperative Decision-Making for Resectability

Colorectal Liver Metastases

Hepatocellular Cancer and Intrahepatic Cholangiocarcinoma

Perihilar Cholangiocarcinoma

Gallbladder Cancer

QUALITY MEASURES

CHAPTER 14: Liver Resection for Colorectal Liver Metastases

CRITICAL ELEMENTS

1. Systematic Abdominal Inspection and Intraoperative Ultrasound

Rationale

Systematic abdominal inspection

Staging laparoscopy

Systematic intraoperative liver ultrasound

Technical Aspects

Abdominal inspection

Intraoperative ultrasound

2. Resection of Planned Lesions to Macroscopically Negative Margins

Rationale

Specimen orientation and margin assessment

Nodal resection

Technical Aspects

Access approach

Parenchymal transection

Portal lymphadenectomy

CHAPTER 15: Liver Resection for Hepatocellular Carcinoma

CRITICAL ELEMENTS

1. Laparoscopic or Open Inspection of the Abdomen and Liver

Rationale

Technical Aspects

Laparoscopic versus open inspection

Intraoperative ultrasound

2. All Lesions Should be Resected to Macroscopically Negative Margins

Rationale

Definition of margins

Nodal sampling

Technical Aspects

CHAPTER 16: Cholangiocarcinoma

CRITICAL ELEMENTS

1. Resection of Primary Tumor to Microscopically Negative Margins

Rationale

Hilar cholangiocarcinoma

Intrahepatic cholangiocarcinoma

Technical Aspects

2. Routine Portal Lymphadenectomy With Selective Sampling of Aortocaval and Retroperitoneal Nodes

Rationale

Hilar cholangiocarcinoma

Intrahepatic cholangiocarcinoma

Technical Aspects

INTRODUCTION

METHODOLOGY

FINDINGS

R0 Resection

Survival

Perioperative Morbidity

CONCLUSION

INTRODUCTION

METHODOLOGY

FINDINGS

Distal Bile Duct Margin

Proximal Bile Duct Margin

Proximal and Distal Margins

CONCLUSION

CHAPTER 17: Gallbladder Cancer

CRITICAL ELEMENTS

1. Selective Staging Laparoscopy Prior to Resection of Gallbladder Cancer

Rationale

Incidental gallbladder cancer

Per primum gallbladder cancer

Technical Aspects

2. Microscopically Complete (R0) Resection of Local Tumor

Rationale

Anatomic IVb and V segmentectomy versus wedge resection of the gallbladder bed

Bile duct resection

Technical Aspects

3. Routine Portal Lymphadenectomy, with Selective Sampling of Aortocaval and Retroperitoneal Nodes

Rationale

Technical Aspects

4. Port Site Excision Need Not be Performed Routinely for Incidentally Discovered Gallbladder Cancer

Rationale

Synoptic Operative Report: Gallbladder Cancer

Synoptic Operative Report: Hepatocellular Carcinoma

Synoptic Operative Report: Hilar Cholangiocarcinoma

Synoptic Operative Report: Intrahepatic Cholangiocarcinoma

Synoptic Operative Report: Metastatic Colon Cancer

COMMENTARY: HEPATOBILIARY SECTION

Index

 

An aparitie	25/09/2022
Autor	AMERICAN COLLEGE OF SURGEONS CANCER RESEARCH PROGRAM
Dimensiuni	152 x 229 mm
Editura	LWW
Format	Paperback
ISBN	9781975153076
Limba	Engleza
Nr pag	560
Versiune digitala	DA