endosergЭндокринная хирургияEndocrine Surgery2306-35132310-3965Типография «Печатных дел Мастер»10.14341/serg12775endoserg-12775Research ArticleОбзорReviewРезекционные вмешательства или динамическое наблюдение в тактике ведения больных со спорадическими нефункционирующими нейроэндокринными опухолями поджелудочной железы Т1 (обзор литературы)Pancreatic resections or observation in management of sporadic non-functioning stage T1 neuroendocrine tumors of the pancreas (PNET) (literature review)https://orcid.org/0000-0001-9742-3955СалимгерееваД. А.SalimgereevaD. A.

Салимгереева Диана Артуровна 

Researcher ID: GLV-1524-2022; Scopus Author ID: 57222037630

111123, г. Москва, шоссе Энтузиастов, д. 86 

Diana A. Salimgereeva

Researcher ID: GLV-1524-2022; Scopus Author ID: 57222037630

86, Shosse Entuziastov, 111123 Moscow

d.salimgereeva@mknc.ruhttps://orcid.org/0000-0001-8369-5116ФейдоровИ. Ю.FeidorovI. Y.

Фейдоров Илья Юрьевич, к.м.н.

Москва

Ilia Y. Feidorov

 

i.feidorov@mknc.ruhttps://orcid.org/0000-0003-3107-3731ХатьковИ. Е.KhatkovI. E.

Хатьков Игорь Евгеньевич, д.м.н., профессор, академик РАН

Москва

Igor E. Khatkov, MD, PhD, Professor

 

i.hatkov@mknc.ruГБУЗ «Московский клинический научный центр им. А.С. Логинова» Департамента здравоохранения города МосквыРоссияMoscow Clinical Scientific Center named after Loginov MHDRussian Federation2023110320231713541Copyright © Салимгереева Д.А., Фейдоров И.Ю., Хатьков И.Е., 20232023Салимгереева Д.А., Фейдоров И.Ю., Хатьков И.Е.Salimgereeva D.A., Feidorov I.Y., Khatkov I.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.surg-endojournals.ru/jour/article/view/12775

Доступность современных высокоточных методов диагностики привела к увеличению выявляемости нейроэндокринных неоплазий поджелудочной железы. Если при локализованных функционирующих опухолях необходимость оперативного лечения не вызывает сомнений, то способа объективизации выбора тактики при нефункционирующих бессимптомных нейроэндокринных опухолях поджелудочной железы, за исключением размера опухоли, в настоящее время нет.

Тактика лечения бессимптомных нефункционирующих нейроэндокринных опухолей Т1 (размером менее 2 см) остается спорной. Согласно данным литературы, оперативное лечение образований до 2 см не всегда позволяет достичь увеличения выживаемости. В то же время даже в высокопотоковых центрах операции на поджелудочной железе обладают высокой частотой осложнений и летальностью. Проспективных рандомизированных исследований, которые бы сравнивали наблюдение и оперативное лечение, на данный момент не опубликовано. Зарубежные клинические рекомендации неоднозначно отвечают на вопрос о тактике лечения подобных неоплазий, в то время как в отечественных данная проблема не освещается вовсе. Рекомендации опираются на данные гетерогенных ретроспективных исследований, поэтому задачей научного поиска является определение критериев отбора пациентов для динамического наблюдения или оперативного лечения.

В данной статье представлен обзор 60 научных публикаций, освещающих проблему.

The availability of modern high-precision diagnostic methods increased the detection rate of pancreatic neuroendocrine neoplasia (pNEN). There is no doubt concerning the necessity of surgical treatment for localized functioning tumors, whilecurrently there is no objective way to choose the tactic for non-functioning asymptomatic neuroendocrine tumors of the pancreas (pNET) with the exception of the tumor size.

Treatment tactics for non-functioning asymptomatic T1 neuroendocrine tumors (less 2 cm in size) are debatable. According to literature surgical treatment for lesions less than 2 cm does not always increase survival. In the same time even in high-volume centers pancreatic surgery shows high morbidity and mortality rate. Prospective randomized trials comparing surveillance and operative treatment are not published yet, as far as authors concerned. International guidelines answer the question of treatment such neoplasms ambiguously, while national Russian recommendations do not cover the topic. Guidelines are based on heterogeneous retrospective studies; therefore, the aim of scientific research is to determine reliable criteria for patient selection for dynamic observation or surgical treatment.

This article provides an overview of 60 scientific publications covering the problem.

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The authors declare that there are no conflicts of interest present.