Original title: High-risk groups of pancreatic diseases It is recommended to be screened regularly after the age of 50.
Text: Guangzhou**Quan**Reporter He Xuehua.
What is the latest progress in pancreatic surgery, which is known as the "pearl" of abdominal surgery?Who needs to be screened regularly for pancreatic hidden dangers?Recently, the 2023 South China International Pancreatic Precision Diagnosis and Treatment Forum was held in Guangzhou, and Professor Chen Rufu, Vice President of the Guangdong Academy of Medical Sciences and Director of the Pancreas Center of Guangdong Provincial People's Hospital, shared the latest progress in the diagnosis and treatment of pancreatic cancer.
*: New technology helps patients to preserve their organs and functions.
The pancreas is hidden in the posterior peritoneum of the human body, deep in the upper abdomen of the human body, adjacent to the liver, gall bladder, duodenum and other important organs, and pancreatic cancer is known as the "king of cancer" because of its difficult diagnosis and treatment. According to the Guidelines for the Diagnosis and Treatment of Pancreatic Cancer (2022 Edition) issued by the General Office of the National Health Commission, the incidence of pancreatic cancer has shown a significant upward trend at home and abroad in recent years, accounting for the sixth place in malignancy-related mortality.
28-year-old Ms. Chen (pseudonym) accidentally found a mass growing in the uncinate process of the pancreas during a physical examination 2 years ago, considering it as a cystic tumor of the pancreas, and many large hospitals said that "pancreaticoduodenectomy is needed", the scope of the operation is large, the difficulty is high, the digestive tract needs to be reconstructed a lot, and she also faces the risk of serious complications after surgery, she hesitated for 2 years and did not make up her mind to operate. In the end, she found Professor Chen Rufu's team and obtained a robot-assisted pancreatic head resection, with only about 50 milliliters of blood.
In the past, most of the pancreatic diseases such as pancreatic cancer were operated by traditional surgery, because of the special location of the pancreas, it is easy to destroy other organs during resection, which is more traumatic, the prognosis is poor, and cancer cells are prone to metastasis. Chen Rufu introduced that the promotion and application of minimally invasive surgical technology for pancreatic cancer has made the current surgical effect much better than 10 years ago, and the combined neurolymphatic dissection created by the team has improved the prognosis and increased the 3-year survival rate by 25%.
According to reports, in the Provincial Medical Pancreas Center, with the help of laparoscopic and robot-assisted minimally invasive technology, more than 200 cases of pancreatic surgery to preserve organs and functions have been successfully implemented, such as duodenal pancreatic head resection, distal pancreatectomy with spleen preservation, local resection of pancreatic tumors, and mid-pancreatic resection.
The "nanosecond knife" technology is a new type of minimally invasive ablation technology for tumors that Professor Chen Rufu's team is tackling. The nanosecond pulse tumor ablation system releases nanosecond high-pressure pulses through the ablation probe to break through the cell membrane and form nano-scale permanent perforations on the tumor cells, disrupting the intracellular homeostasis and ultimately apoptosis of the tumor, thus being replaced by new healthy cells. On August 9 this year, the team performed nanosecond pulse precision ablation for a patient with locally advanced pancreatic cancer who had lost the opportunity for surgery, which was also the first operation for pancreatic cancer with the "nanosecond knife" technology in China.
Specific ablation does not produce heat energy, and only acts on tumor cells within the range of the probe**, so there will be no 'accidental injury', and it can protect the blood vessels around the tumor and even inside the tumor, so that the patient's complications are significantly reduced, especially suitable for pancreatic malignant tumors adjacent to important blood vessels, bile ducts, and pancreatic ducts. Chen Rufu said. He introduced that 4 cases have been successfully implemented so far, and the national multi-center clinical study has been officially launched.
In order to promote the above-mentioned new surgical techniques, the forum established grassroots alliances such as the Guangdong Pancreatic Minimally Invasive Alliance, which will strengthen relevant training in grassroots hospitals and help the diagnosis and treatment of pancreatic cancer.
Prevention: High-risk patients should be screened regularly after age 50.
Pancreatic cancer is one of the most lethal solid tumors in the world, with a mortality rate of up to 90% within 1 year for patients without the chance of surgery. In addition, because pancreatic cancer does not show specific symptoms in the early stage, more than 70% of patients in clinical practice are found too late and lose the opportunity for surgery, and the survival rate is not optimistic. Chen Rufu emphasized that although diagnostic technology is improving and surgical methods are improving, early screening and early diagnosis are still very important in order to improve the long-term survival rate.
He introduced that people's vigilance against pancreatic diseases has increased, and after early detection of symptoms, if targeted examinations such as tumor markers are carried out, it can help the early detection of pancreatic cancer. In 2015, the team revealed for the first time in the world that chronic inflammatory response is the mechanism of type 3 diabetes caused by early pancreatic cancer (new-onset diabetes), the proportion of pancreatic cancer in the general population is 15 100,000, and the risk of disease in the new-onset diabetes population is 3 100, and the team successfully transformed the first pancreatic cancer early diagnosis kit that officially entered the clinic to improve the efficiency of pancreatic cancer screening.
In terms of prevention, "genetic factors account for less than 10% of the incidence of pancreatic cancer, and its incidence is more related to unhealthy lifestyles." It is recommended that patients with chronic pancreatitis, diabetes, as well as long-term smoking, heavy drinking, high-fat diet, and obese people, should be screened regularly for pancreatic cancer after the age of 50, Chen Rufu said. Screening can be carried out by taking blood to check for tumor markers and abdominal CT, and it is recommended to check 1-2 times a year to identify possible cancer risks as soon as possible.
*: Guangzhou**.