Pancreatoduodenectomy using a no-touch isolation technique.
Pancreatoduodenectomy using a no-touch isolation technique.
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DOI：
10.1016/j.amjsurg.2008.06.035
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发表时间：
2010-05-01
影响因子：
3
通讯作者：
Baba, Hideo
中科院分区：
文献类型：
--
作者：
Hirota, Masahiko;Kanemitsu, Keiichiro;Baba, Hideo
背景：胰十二指肠切除术是壶腹周围肿瘤唯一有效的治疗方法。由于外科医生通常在胰十二指肠切除术中抓住肿瘤，该手术可能增加挤压癌细胞并使其进入门静脉、腹膜后和/或腹膜腔的风险。为了克服这些问题，我们开发了一种无接触胰十二指肠切除术的手术技术。方法：自2005年3月至2008年5月，42例患者采用该技术进行手术。对切除的边缘进行显微分析。结果：我们描述了一种采用无接触隔离技术进行胰十二指肠切除术的技术。我们切除肿瘤，将其包裹在Gerota的筋膜内，沿着肠系膜上动脉和腹主动脉的右表面横切腹膜后边缘，而不抓住肿瘤。结论：无接触胰十二指肠切除术有许多潜在的优点，值得在未来的随机对照试验中进一步研究。
BACKGROUND: Pancreatoduodenectomy is the only effective treatment for cancers of the periampullary region. Because surgeons usually grasp tumors during pancreatoduodenectomy, this procedure may increase the risk of squeezing and shedding the cancer cells into the portal vein, retroperitoneum, and/or peritoneal cavity. In an effort to overcome these problems, we have developed a surgical technique for no-touch pancreatoduodenectomy.METHODS: From March 2005 through May 2008, 42 patients have been operated on following this technique. Resected margins were microscopically analyzed.RESULTS: We describe a technique for pancreatoduodenectomy using a no-touch isolation technique. We resect cancers with wrapping them within Gerota's fascia and transect the retroperitoneal margin along the right surface of the superior mesenteric artery and abdominal aorta without grasping tumors.CONCLUSIONS: No-touch pancreatoduodenectomy has many potential advantages that merit further investigation in future randomized controlled trials.