Pancreatic cancer is a leading cause of cancer-related death worldwide, and its burden is destined to increase. Multimodal treatment is crucial to achieve a cure, but standardization is far to come. Borderline resectable disease is the most challenging situation to face. An anatomically resectable disease may hide a biologically aggressive or undiagnosed systemic disease. Whether the patient has to undergo surgery first or after locoregional or systemic therapy is still unknown. Decision-making stands on low-quality evidences since RCTs are lacking. Neoadjuvant treatment may downstage the tumor and treat an early systemic disease, selecting patients for surgery in order to achieve a margin-free resection and avoid early recurrences and useless pancreatectomies. Resectable patients without other worrisome features may benefit from a surgery-first approach, while all other nonmetastatic patients should be enrolled in trials to rule out the outcomes of neoadjuvant treatments.
Part of the book: Advances in Pancreatic Cancer
Colon cancer is the third most common cancer in man and woman in the developed world. Laparoscopic right colectomy is the standard of care for right colon cancer. Since the first report on laparoscopic approach in 1991, the surgical technique has been improved and currently all procedure is performed intracorporeally. The ileo-colic anastomosis can be performed either intracorporeal and extracorporeal: the differences in clinical outcome, complications rate, hospital stay and quality of life between that two techniques are not still clear and a large number of studies has been published about that. According to most recent meta-analysis, intracorporeal anastomosis have showed better outcome in anastomotic leakage rate, surgical site infection rate, development of incisional hernia, postoperative pain and recovery of gastrointestinal function.
Part of the book: Colorectal Cancer