摘要
AIM:To evaluate the surgical outcomes following radical antegrade modular pancreatosplenectomy (RAMPS) for pancreatic cancer. METHODS:Twenty-four patients underwent RAMPS with curative intent between January 2005 and June 2009 at the National Cancer Center, South Korea. Clinicopathologic data, including age, sex, operative findings, pathologic results, adjuvant therapy, postop-erative clinical course and follow-up data were retro-spectively collected and analyzed for this study. RESULTS:Twenty-one patients (87.5%) underwent distal pancreatectomy and 3 patients (12.5%) underwent total pancreatectomy using RAMPS. Nine patients (37.5%) underwent combined vessel resection, including 8 superior mesenteric-portal vein resections and 1 celiac axis resection. Two patients (8.3%) underwent combined resection of other organs, including the colon, stomach or duodenum. Negative tangential margins were achieved in 22 patients (91.7%). The mean tumor diameter for all patients was 4.09 ± 2.15 cm. The 2 patients with positive margins had a mean diameter of 7.25 cm. The mean number of retrieved lymph nodes was 20.92 ± 11.24 and the node positivity rate was 70.8%. The median survival of the 24 patients was 18.23 ± 6.02 mo. Patients with negative margins had a median survival of 21.80 ± 5.30 mo and those with positive margins had a median survival of 6.47 mo (P = 0.021). Nine patients (37.5%) had postoperative complications, but there were no postoperative mortalities. Pancreatic fistula occurred in 4 patients (16.7%):2 patients had a grade A fistula and 2 had a grade B fistula. On univariate analysis, histologic grade, positive tangential margin, pancreatic fistula and adjuvant therapy were significant prognostic factors for survival. CONCLUSION:RAMPS is a feasible procedure for achieving negative tangential margins in patients with carcinoma of the body and tail of the pancreas.
AIM: To evaluate the surgical outcomes following radi- cal antegrade modular pancreatosplenectomy (RAMPS) for pancreatic cancer. METHODS: Twenty-four patients underwent RAMPS with curative intent between January 2005 and June 2009 at the National Cancer Center, South Korea. Clinicopathologic data, including age, sex, operative findings, pathologic results, adjuvant therapy, postop- erative clinical course and follow-up data were retro- spectively collected and analyzed for this study. RESULTS: Twenty-one patients (87.5%) underwent distal pancreatectomy and 3 patients (12.5%) under- went total pancreatectomy using RAMPS. Nine patients (37.5%) underwent combined vessel resection, includ- ing 8 superior mesenteric-portal vein resections and 1 celiac axis resection. Two patients (8.3%) underwent combined resection of other organs, including the co- lon, stomach or duodenum. Negative tangential mar- gins were achieved in 22 patients (91.7%). The mean tumor diameter for all patients was 4.09±2.15 cm. The 2 patients with positive margins had a mean diam- eter of 7.25 cm. The mean number of retrieved lymph nodes was 20.92±11.24 and the node positivity rate was 70.8%. The median survival of the 24 patients was 18.23±6.02 mo. Patients with negative margins had a median survival of 21.80±5.30 mo and those with positive margins had a median survival of 6.47 mo (P = 0.021). Nine patients (37.5%) had postoperative complications, but there were no postoperative mortal- ities. Pancreatic fistula occurred in 4 patients (16.7%): 2 patients had a grade A fistula and 2 had a grade B fistula. On univariate analysis, histologic grade, posi- tive tangential margin, pancreatic fistula and adjuvant therapy were significant prognostic factors for survival. CONCLUSION: RAMPS is a feasible procedure for achieving negative tangential margins in patients with carcinoma of the body and tail of the pancreas.
关键词
胰腺癌
模块化
手术
顺行
程序
平均直径
临床资料
辅助治疗
Carcinoma
Pancreas
Surgical resection
Sur-vival
Radical antegrade modular pancreatosplenectomy