Initial experience with laparoscopic radical antegrade modular pancreatosplenectomy for left-sided pancreatic cancer in a single institution: technical aspects and oncological outcomes.
Initial experience with laparoscopic radical antegrade modular pancreatosplenectomy for left-sided pancreatic cancer in a single institution: technical aspects and oncological outcomes.
复制标题
DOI：
10.1186/s12893-016-0200-z
复制
发表时间：
2017-01-07
期刊：
影响因子：
1.9
通讯作者：
Hong TH
中科院分区：
文献类型：
--
作者：
Kim EY;Hong TH
在胰腺癌时代，由于技术困难和对肿瘤安全性的担忧，腹腔镜手术的频率较低。根治性顺行模块化胰脾切除术（RAMPS）预计有助于在根治性淋巴结清扫期间获得阴性边缘。我们假设，由于其独特的功能，其作为腹腔镜应用也是有利的。2011年7月至2016年4月，对精心选择的左侧胰腺癌患者进行了15例腹腔镜RAMPS。通常使用5个套管针，手术操作和解剖范围与Strasberg描述的开放RAMPS相似或相同。审查并分析了所有病历和随访数据。所有患者均患有胰腺导管腺癌。平均手术时间为219.3 ± 53.8 min，估计失血量为250 ± 70 ml。术后住院时间为6.1 ± 1.2天，2例患者（13.3%）发生尿潴留。中位淋巴结回收数为18.1 ± 6.2，均为阴性切缘。中位随访时间为46.0个月，3年无病生存率和总生存率分别为56.3%和74.1%。我们的早期经验，腹腔镜RAMPS取得了可行的围手术期的结果，伴随着可接受的生存结局。腹腔镜RAMPS可能是一个安全的和肿瘤学上可行的程序，在精心挑选的左侧胰腺癌患者。
Laparoscopic surgery has been performed less frequently in the era of pancreatic cancer due to technical difficulties and concerns about oncological safety. Radical antegrade modular pancreatosplenectomy (RAMPS) is expected to be helpful to obtain a negative margin during radical lymph node dissection. We hypothesized that it would also be favorable as a laparoscopic application due to unique features. Fifteen laparoscopic RAMPS for well-selected patients with left-sided pancreatic cancer were performed from July 2011 to April 2016. Five trocars were usually used, and the operative procedures and range of dissection were similar to or the same as those of open RAMPS described by Strasberg. All medical records and follow-up data were reviewed and analyzed. All patients had pancreatic ductal adenocarcinoma. Mean operative time was 219.3 ± 53.8 min, and estimated blood loss was 250 ± 70 ml. The length of postoperative hospital stay was 6.1 ± 1.2 days, and postoperative morbidities developed in two patients (13.3%) with urinary retention. The median number of retrieved lymph nodes was 18.1 ± 6.2 and all had negative margins. Median follow-up time was 46.0 months, and the 3-year disease free survival and overall survival rates were 56.3% and 74.1%, respectively. Our early experience with laparoscopic RAMPS achieved feasible perioperative results accompanied by acceptable survival outcomes. Laparoscopic RAMPS could be a safe and oncologically feasible procedure in well-selected patients with left-sided pancreatic cancer.
登录
查看更多内容
DOI：
10.1016/j.jamcollsurg.2011.10.008
发表时间：
2012-01-01
影响因子：
5.2
作者：
Mitchem, Jonathan B.;Hamilton, Nicholas;Strasberg, Steven M.
通讯作者：
Strasberg, Steven M.
影响因子：
3.2
作者：
Fernandez-Cruz, Laureano;Cosa, Rebeca;Navarro, Salvador
通讯作者：
Navarro, Salvador
影响因子：
3.5
作者：
Sui, Cheng-Jun;Li, Bin;Zhou, Yan-Ming
通讯作者：
Zhou, Yan-Ming
影响因子：
3.8
作者：
Bassi, C;Dervenis, C;Buchler, M
通讯作者：
Buchler, M
影响因子：
3.2
作者：
Christein, JD;Kendrick, ML;Farnell, MB
通讯作者：
Farnell, MB