Laparoscopic Radical Antegrade Modular Pancreatosplenectomy with Vascular Resection for Pancreatic Cancer: Tips and Tricks
Laparoscopic Radical Antegrade Modular Pancreatosplenectomy with Vascular Resection for Pancreatic Cancer: Tips and Tricks
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腹腔镜根治性顺行模块化胰脾切除术联合血管切除术治疗胰腺癌：提示和技巧
DOI：
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发表时间：
2020
影响因子：
3.2
通讯作者：
A. Iannelli
中科院分区：
文献类型：
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作者：
E. Rosso;S. Frey;G. Zimmitti;A. Manzoni;M. Garatti;A. Iannelli
腹腔镜根治性顺行胰脾切除术（L-RAMPS）联合血管切除术治疗胰腺癌在文献中很少报道。在腹腔镜下实现安全的根治性切除需要几个关键步骤，同时要尊重肿瘤学的根治性原则。为了本研究的目的，回顾性分析了Prominent收集的关于接受根治性顺行模块式胰脾切除术（RAMPS）的连续系列患者的数据。根据手术入路和血管切除的需要将患者分为两组，并对数据进行比较。详细报告了手术技术，重点是血管切除的不同方式。2014年7月至2018年10月期间，23例患者（男性/女性比例，12/11;平均年龄，73岁）在我们的机构接受了RAMPS。其中，17例采用腹腔镜方法，6例采用标准开放方法。开放组的所有患者均接受了复杂的血管重建，而17例患者中有4例（23.5%）接受了腹腔镜血管切除术。腹腔镜入路中的1例患者需要结合两种入路进行血管重建和移植物插入。两组无死亡率，并发症发生率和手术时间相似。当由具有腹腔镜手术经验的高级胰腺外科医生进行时，L-RAMPS联合血管切除术在选定病例中是可行和安全的。
Laparoscopic radical antegrade modular pancreatosplenectomy (L-RAMPS) with vascular resection for pancreatic cancer has been rarely reported in the literature. Several critical steps are required to achieve a safe radical resection under laparoscopy while respecting oncologic principles of radicality. Prospectively collected data on a consecutive series of patients undergoing radical antegrade modular pancreatosplenectomy (RAMPS) were retrospectively reviewed for the purpose of this study. Patients were divided into two groups based on the surgical approach and the need for vascular resection, and data were compared. The surgical technique is reported in detail focusing on the different modalities of vascular resection. Twenty-three patients (male/female ratio, 12/11; mean age, 73 years) underwent RAMPS between July 2014 and October 2018 at our institution. Of these, 17 had a laparoscopic approach and six a standard open approach. All patients in the open group underwent complex vascular reconstructions while four out of 17 (23.5%) underwent laparoscopic vascular resection. One patient in the laparoscopic approach required a vascular reconstruction with graft interposition, which combined the two approaches. There was no mortality, and the complication rate and the duration of surgery were comparable between the two groups. L-RAMPS with vascular resection is feasible and safe in selected cases when performed by advanced pancreatic surgeons with experience in laparoscopic surgery.
影响因子：
2.9
作者：
Ocuin, Lee M.;Miller-Ocuin, Jennifer L.;Zureikat, Amer H.
通讯作者：
Zureikat, Amer H.