Organ-or function-preservation surgery is recommended, but who is a candidate?

Sep 29, 2026

Uploaded by Melati

Editorial discussing organ- or function-preservation surgery, emphasizing that postoperative recovery and quality of life matter alongside survival. It reviews a reported case series using pancreatic head sparing surgery (PHSS) for solid pseudopapillary tumor in patients with dorsal pancreas agenesis (ADP), noting promising outcomes but limited sample size and follow-up duration. It argues that recommending PHSS requires careful patient selection and comprehensive counseling, oncologic risk assessment, response evaluation, surveillance planning, and interpretation of SPT and ADP clinical characteristics.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages2

Reading Time5 min

AccessFree to download

Editorial

Rationale for organ- and function-preservation surgery

Review of PHSS for SPT with dorsal pancreas agenesis

Limits of evidence and need for careful candidate selection

J Chin MedAssoc EDITORIAL Organ-or function-preservation surgery is recommended, but who is a candidate? Chia-Hao Liua,b,c, Szu-Ting Yanga,b,c, Peng-Hui Wanga,b,c,d,* aDepartment of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; bInstitute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC; cFemale Cancer Foundation, Taipei, Taiwan, ROC; dDepartment of Medical Research, China Medical University Hospital, Taichung, Taiwan, ROC With the continuing development of advanced technology and the progression of medicine, many injured organs in the human body can be managed by a surgical approach, regardless of whether they are trauma- or non-trauma (diseases or aging process)-related.1–3 Minimally invasive surgical (MIS) treatment becomes more and more popular, and MIS has been in place of many traditional surgical approaches for these injured organs in recent decades.2–4 Although life-saving is the most critical issue for any disease treatment, postoperative recovery and quality of life should always be of concerned.5 Therefore, many advanced technologies, such as regenerative medicine, organ transplantation, and three-dimension-printed custom-made prosthetic reconstructions, etc., are reported to effectively assist in maintaining the basic or alternative function of damaged organs and/ or tissue. However, by contrast, if accurate and precise preoperative evaluation and an appropriate surgical plan are conducted, minimally traumatic sparing organ and establishment of the physiological and morphological function of damaged tissues and/or organs may minimize the risk of overtreatment and avoid the subsequent severe postoperative sequelae without the need for further investment in new technology.6 All contribute to the re-consideration of the old proverb “to do more and to lose more.”7 The recent publication in the October issue of the Journal of the Chinese Medical Association entitled “Pancreatic head sparing surgery for solid pseudopapillary tumor in patients with agenesis of the dorsal pancreas,” showed the feasibility and possible safety of using sparing surgery of the pancreatic head (pancreatic head sparing surgery [PHSS]) in the management of patients with agenesis of the dorsal pancreas (ADP) accompanied by a solid pseudopapillary tumor (SPT) .8 The authors retrospectively enrolled three patients with ADP accompanied with SPT who were treated with PHSS, and the results showed all patients who were alive ranged from 22 * Address correspondence. Dr. Peng-Hui Wang, Department of Obstetricsand Gynecology, Taipei Veterans General Hospital, 201, Section 2, Shi-Pai Road, Taipei 112, Taiwan, [ROC. E-mail addresses: phwang@vghtpe.gov.tw](ROC. E-mail addresses: phwang@vghtpe.gov.tw); [pongpongwang@gmail.com](pongpongwang@gmail.com) (P.-H. Wang). Conflicts of interest: Dr. Peng-Hui Wang, an editorial board member at the Journal of the Chinese Medical Association, had no role in the peer review process of or decision to publish this article. The other authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article. Journal of Chinese Medical Association. (2023) 86: 3-4. Received November 4, 2022; accepted November 5, 2022. doi: 10. 1097/JCMA.0000000000000848. Copyright © 2022, the Chinese Medical Association. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/](http://creativecommons.org/licenses/)[ ](http://creativecommons.org/licenses/)[by-nc-nd/4.0/](by-nc-nd/4.0/)) months to 75 months, even though one patient could not be totally resected for her SPT.8 Additionally, the authors evaluated 28 patients with SPT without ADP, and the outcomes of these patients were also excellent with a 100% of 20-year overall survival (OS) rate.8 Then, based on the concept of preservation of pancreas function and/or avoidance of pancreatic insufficiency, the

FAQs

Why does the editorial emphasize organ- or function-preservation surgery beyond survival?

It highlights that postoperative recovery and quality of life are essential concerns after treatment, so preservation strategies can help avoid unnecessary harm and severe sequelae.

What procedure and patient group are discussed in relation to pancreatic head sparing surgery (PHSS)?

The editorial focuses on PHSS used for solid pseudopapillary tumor in patients with dorsal pancreas agenesis (ADP), particularly where preserving pancreatic function is important.

What concerns does the editorial raise about the strength of the published conclusions?

It points out the small number of enrolled patients and a relatively short median follow-up, noting no long-term follow-up beyond 10 years.

Sep 29, 2026

Uploaded by Melati