Anterior versus posterior radical antegrade modular pancreatosplenectomy for pancreatic body and tail cancer: an inverse probability of treatment weighting with survival analysis
Anterior versus posterior radical antegrade modular pancreatosplenectomy for pancreatic body and tail cancer: an inverse probability of treatment weighting with survival analysis
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前路与后路根治性顺行模块化胰脾切除术治疗胰体尾癌：生存分析的治疗权重逆概率
DOI：
10.1007/s00595-023-02651-7
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发表时间：
2023
期刊：
影响因子：
2.5
通讯作者：
Mizuno Shugo
中科院分区：
文献类型：
--
作者：
Kuriyama Naohisa;Maeda Koki;Shinkai Toru;Ito Takahiro;Gyoten Kazuyuki;Hayasaki Aoi;Fujii Takehiro;Iizawa Yusuke;Murata Yasuhiro;Tanemura Akihiro;Kishiwada Masashi;Nagata Motonori;Ichikawa Shuhei;Mizuno Shugo
根治性顺行胰脾切除术（RAMPS）是治疗胰体尾癌的标准手术。RAMPS有两种类型：前部和后部，但其适应症和手术结果尚不清楚。我们比较了手术的结果，术后过程中，前后RAMPS之间的预后。MethodsBetween 2007年和2020年，105例连续患者接受RAMPS胰腺体尾癌分为前RAMPS组（n= 30）和后RAMPS组（n= 75）。为了调整术前特征和术中程序的差异，使用倾向scores.ResultsAfter IPTW调整，后RAMPS组的术后体温和前RAMPS组的引流物排出量显著降低，从术后第1天（POD）到第3天，但两组之间在术后并发症、复发模式或预后方面没有差异。关于多排螺旋CT（MD-CT）的诊断能力，直接肿瘤累及左肾上腺，敏感性和特异性分别为100%和90.0%，foreign.Conclusionpancreatic体尾癌没有明显的术前直接肿瘤累及左肾上腺的MD-CT可能是足够的适应症前RAMPS。
PurposeRadical antegrade modular pancreatosplenectomy (RAMPS) is a standard procedure for patients with pancreatic body and tail cancer. There are two types of RAMPS: anterior and posterior, but their indications and surgical outcomes remain unclear. We compared the surgical outcomes, postoperative course, and prognosis between anterior and posterior RAMPS.MethodsBetween 2007 and 2020, 105 consecutive patients who underwent RAMPS for pancreatic body and tail cancers were divided into an anterior RAMPS group (n= 30) and a posterior RAMPS group (n= 75). To adjust for differences in preoperative characteristics and intraoperative procedures, an inverse probability of treatment weighting (IPTW) analysis was done, using propensity scores.ResultsAfter IPTW adjustment, the postoperative body temperature of the posterior RAMPS group and the amount of drain discharge in the anterior RAMPS group were significantly lower, from postoperative days (PODs) 1 to 3, but there were no differences in postoperative complications, recurrence patterns, or prognosis between the two groups. Regarding the diagnostic ability of multidetector-row computed tomography (MD-CT) for direct tumor involvement of the left adrenal gland, the sensitivity and specificity were 100% and 90.0%, respectively.ConclusionPancreatic body and tail cancer without apparent preoperative direct tumor involvement of the left adrenal gland on MD-CT may be sufficient indication for anterior RAMPS.