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Initial experience with radical antegrade modular pancreatosplenectomy in a single institution
Annals of Surgical Treatment and Research ; : 29-36, 2016.
Artículo en Inglés | WPRIM | ID: wpr-135123
ABSTRACT

PURPOSE:

Radical antegrade modular pancreatosplenectomy (RAMPS) is expected to be favorable for obtaining the negative tangential margin with oncologic feasibility through the horizontal dissection in a right-to-left fashion for radical lymph node dissections.

METHODS:

From January 2007 to February 2015, a total of 30 RAMPS and 19 conventional distal pancreatectomy (DP) cases were enrolled. The demographics, perioperative and survival outcomes were compared according to the type of surgery.

RESULTS:

The mean operative time, blood loss and length of hospital stay were similar between 2 groups. Morbidities were reported in 14 cases of RAMPS (46.7%) and 8 cases of DP (42.1%) (P = 0.777). The rate of negative tangential margin (96.2%) and the number of harvested lymph nodes (mean ± standard deviation, 21.5 ± 8.3) were significantly higher in RAMPS group (P = 0.011, P = 0.003, respectively). In terms of survival outcomes, there was no significant difference in regard to the overall 3-year disease-free survival (DFS; 30.4% in RAMPS vs. 35.0% in DP, P = 0.354) or overall survival (OS; 29.9% vs. 29.4%, P = 0.429) between the 2 groups. After exclusion of cases with nodal invasion, however, the RAMPS group had a longer DFS than the DP group (55.6% vs. 27.3%, P = 0.048) although OS was similar without significant difference (42.4% vs. 27.3%, P = 0.197).

CONCLUSION:

RAMPS is a safe and oncologically feasible procedure in left-sided pancreatic cancer by obtaining a successful negative tangential margin and radical lymph node dissection. The authors suggest it could also be useful for local control, especially for the limited left-sided pancreatic cancer without nodal invasion.
Asunto(s)

Texto completo: Disponible Índice: WPRIM (Pacífico Occidental) Asunto principal: Pancreatectomía / Neoplasias Pancreáticas / Accesibilidad Arquitectónica / Demografía / Supervivencia sin Enfermedad / Tempo Operativo / Tiempo de Internación / Escisión del Ganglio Linfático / Ganglios Linfáticos Idioma: Inglés Revista: Annals of Surgical Treatment and Research Año: 2016 Tipo del documento: Artículo

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Texto completo: Disponible Índice: WPRIM (Pacífico Occidental) Asunto principal: Pancreatectomía / Neoplasias Pancreáticas / Accesibilidad Arquitectónica / Demografía / Supervivencia sin Enfermedad / Tempo Operativo / Tiempo de Internación / Escisión del Ganglio Linfático / Ganglios Linfáticos Idioma: Inglés Revista: Annals of Surgical Treatment and Research Año: 2016 Tipo del documento: Artículo