Portal or superior mesenteric vein resection in pancreatoduodenectomy for pancreatic head carcinoma
Portal or superior mesenteric vein resection in pancreatoduodenectomy for pancreatic head carcinoma
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DOI：
10.1002/bjs.9799
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发表时间：
2015-06-01
影响因子：
9.6
通讯作者：
Honda, G.
中科院分区：
文献类型：
--
作者：
Murakami, Y.;Satoi, S.;Honda, G.
BackgroundThe的目的是要确定的附加值门静脉或上级肠系膜静脉（PV/SMV）切除术胰头cancer.MethodsA多中心观察性研究，胰头癌患者进行胰头切除术在2001年和2012年之间在日本的七家医院。比较了行PV/SMV切除术和未行PV/SMV切除术患者的临床病理因素。单变量和多变量analysis.ResultsOf 937例接受胰腺癌切除术的患者，435（464%）有PV/SMV切除术，而其余的502（536%）没有。约715%和639%的PV/SMV切除和未切除的患者分别有淋巴结阳性疾病。接受PV/SMV切除术的患者有更晚期的肿瘤。两组的围手术期死亡率和发病率无差异。多因素分析显示PV/SMV切除不是影响总生存率的独立预后因素（P= 0.268）。在435例PV/SMV切除的患者中，交界性肿瘤与动脉邻接（P= 0.021）和无辅助化疗（P
BackgroundThe aim of this study was to determine the added value of portal or superior mesenteric vein (PV/SMV) resection during pancreatoduodenectomy for pancreatic head carcinoma.MethodsA multicentre observational study was conducted in patients with pancreatic head carcinoma who underwent pancreatoduodenectomy in seven Japanese hospitals between 2001 and 2012. Clinicopathological factors were compared between patients who did and did not undergo PV/SMV resection. Those with an impact on survival were identified by univariable and multivariable analysis.ResultsOf the 937 patients who underwent pancreatoduodenectomy, 435 (464 per cent) had PV/SMV resection, whereas the remaining 502 (536 per cent) did not. Some 715 and 639 per cent of patients with and without PV/SMV resection respectively had lymph node-positive disease. Patients who underwent PV/SMV resection had more advanced tumours. Perioperative mortality and morbidity rates did not differ between the two groups. Multivariable analysis revealed that PV/SMV resection was not an independent prognostic factor for overall survival (P=0268). Among the 435 patients in whom the PV/SMV was resected, borderline resectable tumours with arterial abutment (P=0021) and absence of adjuvant chemotherapy (P