Tiina Vuorela - Academia.edu (original) (raw)

Papers by Tiina Vuorela

Research paper thumbnail of Periodontitis Increases the Risk of Complications after Pancreatic Surgery

Research paper thumbnail of Response to “Re. Longterm Results in Pancreatectomy With and Without Venous Resection: a Comparison of Safety and Complications in Spiral Graft, End to End and Tangential/Patch Reconstruction Techniques”

European Journal of Vascular and Endovascular Surgery, Aug 1, 2022

Research paper thumbnail of Long Term Results of Pancreatectomy With and Without Venous Resection: A Comparison of Safety and Complications of Spiral Graft, End-to-End and Tangential/Patch Reconstruction Techniques

Journal of Vascular Surgery, Nov 1, 2022

Research paper thumbnail of Pasireotide administration after pancreaticoduodenectomy may decrease clinically relevant postoperative pancreatic fistula in high-risk patients with small pancreatic ducts, soft pancreatic parenchyma and cystic or neuroendocrine neoplasia

Pancreatology, Jun 1, 2020

administration after pancreaticoduodenectomy may decrease clinically relevant postoperative pancr... more administration after pancreaticoduodenectomy may decrease clinically relevant postoperative pancreatic fistula in highrisk patients with small pancreatic ducts, soft pancreatic parenchyma and cystic or neuroendocrine neoplasia, Pancreatology,

Research paper thumbnail of Impact of pasireotide on postoperative pancreatic fistulas following distal resections

Langenbeck's Archives of Surgery, Jan 20, 2021

Purpose Postoperative pancreatic fistula (POPF), a difficult complication after surgery, can caus... more Purpose Postoperative pancreatic fistula (POPF), a difficult complication after surgery, can cause peripancreatic fluid collection and infections in the operative area. In addition, pancreatic fluid is corrosive and can lead to postoperative bleeding. Clinically significant grade B and C fistulas (CR-POPF) increase postoperative morbidity, resulting in a prolonged hospital stay. Delaying adjuvant therapy due to fistula formation in cancer patients can affect their prognosis. In this study, we aimed to determine if pasireotide affects fistula formation, and the severity of other complications in patients following pancreatic distal resections. Data and methods Between 2000 and 2016, 258 distal pancreatectomies were performed at Helsinki University Hospital and were included in our analysis. Pasireotide was administered to patients undergoing distal resections between July 2014 and December 2016. Patients received 900-μg pasireotide administered twice daily perioperatively. Other patients who received octreotide treatment were analyzed separately. Complications such as fistulas (POPF), delayed gastric emptying (DGE), postpancreatectomy hemorrhage (PPH), reoperations, and mortality were recorded and analyzed 90 days postoperatively. Results Overall, 47 (18%) patients received pasireotide and 31 (12%) octreotide, while 180 patients (70%) who received neither constituted the control group. There were 40 (16%) clinically relevant grade B and C POPFs: seven (15%) in the pasireotide group, three (10%) in the octreotide group, and 30 (17%) in the control group (p = 0.739). Severe complications categorized as Clavien-Dindo grade III or IV were recorded in 64 (25%) patients: 17 (27%) in the pasireotide group, 4 (6%) in the octreotide group, and 43 (67%) in the control group (p = 0.059). We found no 90-day mortality. Conclusions In this study, pasireotide did not reduce clinically relevant POPFs or severe complications following pancreatic distal resection.

Research paper thumbnail of Pancreatic fibrosis, acinar atrophy and chronic inflammation in surgical specimens associated with survival in patients with resectable pancreatic ductal adenocarcinoma

BMC Cancer, Jan 3, 2022

Background: Pancreatic ductal adenocarcinoma (PDAC), one of the most lethal malignancies, is incr... more Background: Pancreatic ductal adenocarcinoma (PDAC), one of the most lethal malignancies, is increasing in incidence. However, the stromal reaction pathophysiology and its role in PDAC development remain unknown. We, therefore, investigated the potential role of histological chronic pancreatitis findings and chronic inflammation on surgical PDAC specimens and disease-specific survival (DSS). Methods: Between 2000 and 2016, we retrospectively enrolled 236 PDAC patients treated with curative-intent pancreatic surgery at Helsinki University Hospital. All pancreatic transection margin slides were re-reviewed and histological findings were evaluated applying international guidelines. Results: DSS among patients with no fibrosis, acinar atrophy or chronic inflammation identified on pathology slides was significantly better than DSS among patients with fibrosis, acinar atrophy and chronic inflammation [median survival: 41.8 months, 95% confidence interval (CI) 26.0-57.6 vs. 20.6 months, 95% CI 10.3-30.9; log-rank test p = 0.001]. Multivariate analysis revealed that Ca 19-9 > 37 kU/l [hazard ratio (HR) 1.48, 95% CI 1.02-2.16], lymph node metastases N1-2 (HR 1.71, 95% CI 1.16-2.52), tumor size > 30 mm (HR 1.47, 95% CI 1.04-2.08), the combined effect of fibrosis and acinar atrophy (HR 1.91, 95% CI 1.27-2.88) and the combined effect of fibrosis, acinar atrophy and chronic inflammation (HR 1.63, 95% CI 1.03-2.58) independently served as unfavorable prognostic factors for DSS. However, we observed no significant associations between tumor size (> 30 mm) and the degree of perilobular fibrosis (p = 0.655), intralobular fibrosis (p = 0.587), acinar atrophy (p = 0.584) or chronic inflammation (p = 0.453). Conclusions: Our results indicate that the pancreatic stroma is associated with PDAC patients' DSS. Additionally, the more severe the fibrosis, acinar atrophy and chronic inflammation, the worse the impact on DSS, thereby warranting further studies investigating stroma-targeted therapies.

Research paper thumbnail of Association of periodontitis and complications after pancreatic surgery

Research paper thumbnail of Additional file 1 of Pancreatic fibrosis, acinar atrophy and chronic inflammation in surgical specimens associated with survival in patients with resectable pancreatic ductal adenocarcinoma

Research paper thumbnail of Response to “Re. Longterm Results in Pancreatectomy With and Without Venous Resection: a Comparison of Safety and Complications in Spiral Graft, End to End and Tangential/Patch Reconstruction Techniques”

European Journal of Vascular and Endovascular Surgery

Research paper thumbnail of Long Term Results of Pancreatectomy With and Without Venous Resection: A Comparison of Safety and Complications of Spiral Graft, End-to-End and Tangential/Patch Reconstruction Techniques

Journal of Vascular Surgery

Research paper thumbnail of Pasireotide administration after pancreaticoduodenectomy may decrease clinically relevant postoperative pancreatic fistula in high-risk patients with small pancreatic ducts, soft pancreatic parenchyma and cystic or neuroendocrine neoplasia

Pancreatology, 2020

administration after pancreaticoduodenectomy may decrease clinically relevant postoperative pancr... more administration after pancreaticoduodenectomy may decrease clinically relevant postoperative pancreatic fistula in highrisk patients with small pancreatic ducts, soft pancreatic parenchyma and cystic or neuroendocrine neoplasia, Pancreatology,

Research paper thumbnail of Long Term Results of Pancreatectomy With and Without Venous Resection: A Comparison of Safety and Complications of Spiral Graft, End-to-End and Tangential/Patch Reconstruction Techniques

European Journal of Vascular and Endovascular Surgery

Research paper thumbnail of Pancreatic fibrosis, acinar atrophy and chronic inflammation in surgical specimens associated with survival in patients with resectable pancreatic ductal adenocarcinoma

Research paper thumbnail of The effect of pasireotide on post-operative pancreatic fistulas after pancreatic distal resections

Research paper thumbnail of Impact of pasireotide on postoperative pancreatic fistulas following distal resections

Langenbeck's Archives of Surgery, 2021

Postoperative pancreatic fistula (POPF), a difficult complication after surgery, can cause peripa... more Postoperative pancreatic fistula (POPF), a difficult complication after surgery, can cause peripancreatic fluid collection and infections in the operative area. In addition, pancreatic fluid is corrosive and can lead to postoperative bleeding. Clinically significant grade B and C fistulas (CR-POPF) increase postoperative morbidity, resulting in a prolonged hospital stay. Delaying adjuvant therapy due to fistula formation in cancer patients can affect their prognosis. In this study, we aimed to determine if pasireotide affects fistula formation, and the severity of other complications in patients following pancreatic distal resections. Between 2000 and 2016, 258 distal pancreatectomies were performed at Helsinki University Hospital and were included in our analysis. Pasireotide was administered to patients undergoing distal resections between July 2014 and December 2016. Patients received 900-μg pasireotide administered twice daily perioperatively. Other patients who received octreot...

Research paper thumbnail of AB054. P025. Impact of pasireotide on post-operative pancreatic fistulas after pancreatic distal resections

Annals of Pancreatic Cancer

Research paper thumbnail of Periodontitis Increases the Risk of Complications after Pancreatic Surgery

Research paper thumbnail of Response to “Re. Longterm Results in Pancreatectomy With and Without Venous Resection: a Comparison of Safety and Complications in Spiral Graft, End to End and Tangential/Patch Reconstruction Techniques”

European Journal of Vascular and Endovascular Surgery, Aug 1, 2022

Research paper thumbnail of Long Term Results of Pancreatectomy With and Without Venous Resection: A Comparison of Safety and Complications of Spiral Graft, End-to-End and Tangential/Patch Reconstruction Techniques

Journal of Vascular Surgery, Nov 1, 2022

Research paper thumbnail of Pasireotide administration after pancreaticoduodenectomy may decrease clinically relevant postoperative pancreatic fistula in high-risk patients with small pancreatic ducts, soft pancreatic parenchyma and cystic or neuroendocrine neoplasia

Pancreatology, Jun 1, 2020

administration after pancreaticoduodenectomy may decrease clinically relevant postoperative pancr... more administration after pancreaticoduodenectomy may decrease clinically relevant postoperative pancreatic fistula in highrisk patients with small pancreatic ducts, soft pancreatic parenchyma and cystic or neuroendocrine neoplasia, Pancreatology,

Research paper thumbnail of Impact of pasireotide on postoperative pancreatic fistulas following distal resections

Langenbeck's Archives of Surgery, Jan 20, 2021

Purpose Postoperative pancreatic fistula (POPF), a difficult complication after surgery, can caus... more Purpose Postoperative pancreatic fistula (POPF), a difficult complication after surgery, can cause peripancreatic fluid collection and infections in the operative area. In addition, pancreatic fluid is corrosive and can lead to postoperative bleeding. Clinically significant grade B and C fistulas (CR-POPF) increase postoperative morbidity, resulting in a prolonged hospital stay. Delaying adjuvant therapy due to fistula formation in cancer patients can affect their prognosis. In this study, we aimed to determine if pasireotide affects fistula formation, and the severity of other complications in patients following pancreatic distal resections. Data and methods Between 2000 and 2016, 258 distal pancreatectomies were performed at Helsinki University Hospital and were included in our analysis. Pasireotide was administered to patients undergoing distal resections between July 2014 and December 2016. Patients received 900-μg pasireotide administered twice daily perioperatively. Other patients who received octreotide treatment were analyzed separately. Complications such as fistulas (POPF), delayed gastric emptying (DGE), postpancreatectomy hemorrhage (PPH), reoperations, and mortality were recorded and analyzed 90 days postoperatively. Results Overall, 47 (18%) patients received pasireotide and 31 (12%) octreotide, while 180 patients (70%) who received neither constituted the control group. There were 40 (16%) clinically relevant grade B and C POPFs: seven (15%) in the pasireotide group, three (10%) in the octreotide group, and 30 (17%) in the control group (p = 0.739). Severe complications categorized as Clavien-Dindo grade III or IV were recorded in 64 (25%) patients: 17 (27%) in the pasireotide group, 4 (6%) in the octreotide group, and 43 (67%) in the control group (p = 0.059). We found no 90-day mortality. Conclusions In this study, pasireotide did not reduce clinically relevant POPFs or severe complications following pancreatic distal resection.

Research paper thumbnail of Pancreatic fibrosis, acinar atrophy and chronic inflammation in surgical specimens associated with survival in patients with resectable pancreatic ductal adenocarcinoma

BMC Cancer, Jan 3, 2022

Background: Pancreatic ductal adenocarcinoma (PDAC), one of the most lethal malignancies, is incr... more Background: Pancreatic ductal adenocarcinoma (PDAC), one of the most lethal malignancies, is increasing in incidence. However, the stromal reaction pathophysiology and its role in PDAC development remain unknown. We, therefore, investigated the potential role of histological chronic pancreatitis findings and chronic inflammation on surgical PDAC specimens and disease-specific survival (DSS). Methods: Between 2000 and 2016, we retrospectively enrolled 236 PDAC patients treated with curative-intent pancreatic surgery at Helsinki University Hospital. All pancreatic transection margin slides were re-reviewed and histological findings were evaluated applying international guidelines. Results: DSS among patients with no fibrosis, acinar atrophy or chronic inflammation identified on pathology slides was significantly better than DSS among patients with fibrosis, acinar atrophy and chronic inflammation [median survival: 41.8 months, 95% confidence interval (CI) 26.0-57.6 vs. 20.6 months, 95% CI 10.3-30.9; log-rank test p = 0.001]. Multivariate analysis revealed that Ca 19-9 > 37 kU/l [hazard ratio (HR) 1.48, 95% CI 1.02-2.16], lymph node metastases N1-2 (HR 1.71, 95% CI 1.16-2.52), tumor size > 30 mm (HR 1.47, 95% CI 1.04-2.08), the combined effect of fibrosis and acinar atrophy (HR 1.91, 95% CI 1.27-2.88) and the combined effect of fibrosis, acinar atrophy and chronic inflammation (HR 1.63, 95% CI 1.03-2.58) independently served as unfavorable prognostic factors for DSS. However, we observed no significant associations between tumor size (> 30 mm) and the degree of perilobular fibrosis (p = 0.655), intralobular fibrosis (p = 0.587), acinar atrophy (p = 0.584) or chronic inflammation (p = 0.453). Conclusions: Our results indicate that the pancreatic stroma is associated with PDAC patients' DSS. Additionally, the more severe the fibrosis, acinar atrophy and chronic inflammation, the worse the impact on DSS, thereby warranting further studies investigating stroma-targeted therapies.

Research paper thumbnail of Association of periodontitis and complications after pancreatic surgery

Research paper thumbnail of Additional file 1 of Pancreatic fibrosis, acinar atrophy and chronic inflammation in surgical specimens associated with survival in patients with resectable pancreatic ductal adenocarcinoma

Research paper thumbnail of Response to “Re. Longterm Results in Pancreatectomy With and Without Venous Resection: a Comparison of Safety and Complications in Spiral Graft, End to End and Tangential/Patch Reconstruction Techniques”

European Journal of Vascular and Endovascular Surgery

Research paper thumbnail of Long Term Results of Pancreatectomy With and Without Venous Resection: A Comparison of Safety and Complications of Spiral Graft, End-to-End and Tangential/Patch Reconstruction Techniques

Journal of Vascular Surgery

Research paper thumbnail of Pasireotide administration after pancreaticoduodenectomy may decrease clinically relevant postoperative pancreatic fistula in high-risk patients with small pancreatic ducts, soft pancreatic parenchyma and cystic or neuroendocrine neoplasia

Pancreatology, 2020

administration after pancreaticoduodenectomy may decrease clinically relevant postoperative pancr... more administration after pancreaticoduodenectomy may decrease clinically relevant postoperative pancreatic fistula in highrisk patients with small pancreatic ducts, soft pancreatic parenchyma and cystic or neuroendocrine neoplasia, Pancreatology,

Research paper thumbnail of Long Term Results of Pancreatectomy With and Without Venous Resection: A Comparison of Safety and Complications of Spiral Graft, End-to-End and Tangential/Patch Reconstruction Techniques

European Journal of Vascular and Endovascular Surgery

Research paper thumbnail of Pancreatic fibrosis, acinar atrophy and chronic inflammation in surgical specimens associated with survival in patients with resectable pancreatic ductal adenocarcinoma

Research paper thumbnail of The effect of pasireotide on post-operative pancreatic fistulas after pancreatic distal resections

Research paper thumbnail of Impact of pasireotide on postoperative pancreatic fistulas following distal resections

Langenbeck's Archives of Surgery, 2021

Postoperative pancreatic fistula (POPF), a difficult complication after surgery, can cause peripa... more Postoperative pancreatic fistula (POPF), a difficult complication after surgery, can cause peripancreatic fluid collection and infections in the operative area. In addition, pancreatic fluid is corrosive and can lead to postoperative bleeding. Clinically significant grade B and C fistulas (CR-POPF) increase postoperative morbidity, resulting in a prolonged hospital stay. Delaying adjuvant therapy due to fistula formation in cancer patients can affect their prognosis. In this study, we aimed to determine if pasireotide affects fistula formation, and the severity of other complications in patients following pancreatic distal resections. Between 2000 and 2016, 258 distal pancreatectomies were performed at Helsinki University Hospital and were included in our analysis. Pasireotide was administered to patients undergoing distal resections between July 2014 and December 2016. Patients received 900-μg pasireotide administered twice daily perioperatively. Other patients who received octreot...

Research paper thumbnail of AB054. P025. Impact of pasireotide on post-operative pancreatic fistulas after pancreatic distal resections

Annals of Pancreatic Cancer