Surgical management and hormonal secretion in gastroenteropancreatic neuroendocrine tumors
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Abstract
The biological heterogeneity and hormonal hypersecretion of gastroenteropancreatic neuroendocrine tumors (GEP-NETs) cause severe clinical syndromes and increase the risk of perioperative hemodynamic instability. To critically evaluate the impact of the hormonal secretion profile on the planning and success of the surgical approach to GEP-NETs. Methodology: A structured systematic review conducted in accordance with the PRISMA statement, covering 25 high-quality scientific articles published since 2020 in PubMed, SciELO, LILACS, and the scientific journal *Ciencia y Método*. R0 resection is the curative standard of care in localized stages. Hepatic cytoreduction (>90%) and somatostatin analogs prevent carcinoid crises and control symptoms, while laparoscopic enucleation is effective for preserving parenchyma in insulinomas. There is debate regarding the appropriateness of active surveillance versus surgery for incidental pancreatic lesions ≤2 cm due to high surgical morbidity, emphasizing the role of health education in optimizing postoperative adherence. Designing a surgical strategy carefully tailored to the tumor’s secretory function and histopathological profile is essential to maximize patient survival.
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