Objective： To evaluate the feasibility and safety of total mesopancreas excision （TMpE） in the treatment of pancreatic head cancer. Methods： The clinical and pathological data of 120 patients with pancreatic head ...Objective： To evaluate the feasibility and safety of total mesopancreas excision （TMpE） in the treatment of pancreatic head cancer. Methods： The clinical and pathological data of 120 patients with pancreatic head cancer who had undergone TMpE in our center from May 2010 to January 2014 were retrospectively analyzed. Results： The mean operative time was （275.0±50.2） min and the average intra-operative blood loss was （390.0±160.5） mL. Post-operative complications were reported in 45 patients, while no peri-operative death was noted. The specimen margins were measured in three dimensions, and 86 patients （71.6%） achieved R0 resection. Conclusions： TMpE is safe and feasible for pancreatic head cancer and is particularly helpful to increase the R0 resection rate.展开更多
Pancreatic head carcinoma(PHC)is one of the common gastrointestinal malignancies with a high morbidity and poor prognosis.At present,radical surgery is still the curative treatment for PHC.However,in clinical practice...Pancreatic head carcinoma(PHC)is one of the common gastrointestinal malignancies with a high morbidity and poor prognosis.At present,radical surgery is still the curative treatment for PHC.However,in clinical practice,the actual R0 resection rate,the local recurrence rate,and the prognosis of PHC are unsatisfactory.Therefore,the concept of total mesopancreas excision(TMpE)is proposed to achieve R0 resection.Although there have various controversies and discussions on the definition,the range of excision,and clinical prognosis of TMpE,the concept of TMpE can effectively increase the R0 resection rate,reduce the local recurrence rate,and improve the prognosis of PHC.Imaging is of importance in preoperative examination for PHC;however,traditional imaging assessment of PHC does not focus on mesopancreas.This review discusses the application of medical imaging in TMpE for PHC,to provide more accurate preoperative evaluation,range of excision,and more valuable postoperative follow-up evaluation for TMpE through imaging.It is believed that with further extensive research and exploratory application of TMpE for PHC,large-sample and multicenter studies will be realized,thus providing reliable evidence for imaging evaluation.展开更多
Preoperative imaging staging based on tumor,node,metastasis classification cannot be effective to avoid R1 resection because only further improvements in imaging technologies will allow the precise assessment of perin...Preoperative imaging staging based on tumor,node,metastasis classification cannot be effective to avoid R1 resection because only further improvements in imaging technologies will allow the precise assessment of perineural and lymphatic invasion and the occurrence of microscopic tumour deposits in the mesopancreas.However,waiting for further improvements in imaging technologies,total mesopancreas excision remains the only tool able to precisely assess mesopancreatic resection margin status,maximize the guarantee of radicality in cases of negative(R0)mesopancreatic resection margins,and stage the mesopancreas.展开更多
基金Supported by Shanghai municipal hospital burgeoning and leading edge technology projects No.SHDC12014109
文摘Objective： To evaluate the feasibility and safety of total mesopancreas excision （TMpE） in the treatment of pancreatic head cancer. Methods： The clinical and pathological data of 120 patients with pancreatic head cancer who had undergone TMpE in our center from May 2010 to January 2014 were retrospectively analyzed. Results： The mean operative time was （275.0±50.2） min and the average intra-operative blood loss was （390.0±160.5） mL. Post-operative complications were reported in 45 patients, while no peri-operative death was noted. The specimen margins were measured in three dimensions, and 86 patients （71.6%） achieved R0 resection. Conclusions： TMpE is safe and feasible for pancreatic head cancer and is particularly helpful to increase the R0 resection rate.
文摘Pancreatic head carcinoma(PHC)is one of the common gastrointestinal malignancies with a high morbidity and poor prognosis.At present,radical surgery is still the curative treatment for PHC.However,in clinical practice,the actual R0 resection rate,the local recurrence rate,and the prognosis of PHC are unsatisfactory.Therefore,the concept of total mesopancreas excision(TMpE)is proposed to achieve R0 resection.Although there have various controversies and discussions on the definition,the range of excision,and clinical prognosis of TMpE,the concept of TMpE can effectively increase the R0 resection rate,reduce the local recurrence rate,and improve the prognosis of PHC.Imaging is of importance in preoperative examination for PHC;however,traditional imaging assessment of PHC does not focus on mesopancreas.This review discusses the application of medical imaging in TMpE for PHC,to provide more accurate preoperative evaluation,range of excision,and more valuable postoperative follow-up evaluation for TMpE through imaging.It is believed that with further extensive research and exploratory application of TMpE for PHC,large-sample and multicenter studies will be realized,thus providing reliable evidence for imaging evaluation.
文摘Preoperative imaging staging based on tumor,node,metastasis classification cannot be effective to avoid R1 resection because only further improvements in imaging technologies will allow the precise assessment of perineural and lymphatic invasion and the occurrence of microscopic tumour deposits in the mesopancreas.However,waiting for further improvements in imaging technologies,total mesopancreas excision remains the only tool able to precisely assess mesopancreatic resection margin status,maximize the guarantee of radicality in cases of negative(R0)mesopancreatic resection margins,and stage the mesopancreas.
