The São Paulo International Consensus on Minimally Invasive Pancreatic Surgery for Cancer.
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Tustumi Francisco, Calthorpe Lucia, Fotoohi Nora, Ribeiro Thiago Costa, Stolzemburg Lucas Cata Preta, Bettiati Junior Andre L, Gonçalves Caroline de Almeida, de Almeida Ana P Cursino Briet, Giordano Allana M Gomes, de Godoy André Luís, Altenfelder Dante, Nicioli Julia, Guimarães Alexandre C, Requejo Alejandro S, Diniz Alessandro Landskron, Oliveira Alexandre Ferreira, Wei Alice C, de Moricz André, Montagnini Andre L, Visser Brendan C, Chan Carlos H F, de Oliveira Cássio V Cavalcante, Ferrone Cristina R, Asbun Domenech, Jonas Eduard, Ramos Eduardo J B, Nickel Felix, Maia Filipe Kunzler de Oliveira, Apodaca-Torrez Franz Robert, Barreto Savio G, Hewitt D Brock, de Farias Igor Correia, Frigerio Isabella, Jang Jin-Young, Anghinoni Marciano, Boff Marcio F, Belotto Marcos, Giménez Mariano E, Nakamura Masafumi, Katz Matthew H G, Hogg Melissa E, Kendrick Michael L, Luyer Misha D P, Abu Hilal Mohammad, Ikoma Naruhiko, Zyromski Nicholas J, Jarufe Nicolás, Guevara Oscar A, Mazza Oscar, Polanco Patricio M, Amaral Paulo Cezar G, Pinheiro Rodrigo Nascimento, Jeyarajah D Rohan, Gaujoux Sebastien, Shrikhande Shailesh V, Torres Silvio M, Siriwardena Ajith K, Kent Tara S, Hackert Thilo, Pawlik Timothy M, Andraus Wellington, Boggi Ugo, Asbun Horacio J, Alseidi Adnan, Coimbra Felipe José Fernández
Аннотация
METHODS: A scoping literature review informed statement development across five thematic groups: (1) Left Pancreatectomy for Pancreatic Cancer, (2) Pancreatoduodenectomy and Total Pancreatectomy for Pancreatic Cancer, (3) Neuroendocrine Pancreatic Tumors, (4) Patient Evaluation and Surgical Technique, and (5) Implementation, Training, and Innovation. A three-round modified Delphi process was conducted with an international panel of 52 expert pancreas surgeons. Consensus was defined as ≥90 % agreement.
RESULTS: From 2590 publications, 185 studies were selected for inclusion. Fifty-two hepatopancreatobiliary surgeons, with a median of 22 years of experience, achieved consensus through a three-round Delphi process. Ultimately, 22 of the initial 28 statements met the ≥90 % agreement threshold. The resulting recommendations provide evidence-based guidance on minimally invasive pancreas resection for cancer, including neuroendocrine tumors, patient evaluation, program implementation, and innovation.
DISCUSSION: The São Paulo Consensus provides contemporary, evidence-based recommendations to guide the safe and judicious adoption, implementation, and practice of minimally invasive techniques.