دورية أكاديمية
Venous Resection for Locally Advanced Pancreatic Cancer: Time Trend and Outcome Analysis of 65 Consecutive Resections at a High-Volume Center.
| العنوان: | Venous Resection for Locally Advanced Pancreatic Cancer: Time Trend and Outcome Analysis of 65 Consecutive Resections at a High-Volume Center. |
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| المؤلفون: | Caruso R; Sanchinarro University Hospital, General Surgery Department, San Pablo University, CEU, Madrid, Spain., Quijano Y; Sanchinarro University Hospital, General Surgery Department, San Pablo University, CEU, Madrid, Spain., Ferri V; Sanchinarro University Hospital, General Surgery Department, San Pablo University, CEU, Madrid, Spain., Duran H; Sanchinarro University Hospital, General Surgery Department, San Pablo University, CEU, Madrid, Spain., Diaz E; Sanchinarro University Hospital, General Surgery Department, San Pablo University, CEU, Madrid, Spain., Fabra I; Sanchinarro University Hospital, General Surgery Department, San Pablo University, CEU, Madrid, Spain., Malave L; Sanchinarro University Hospital, General Surgery Department, San Pablo University, CEU, Madrid, Spain., Isernia R; Sanchinarro University Hospital, General Surgery Department, San Pablo University, CEU, Madrid, Spain., Pinna E; Sanchinarro University Hospital, General Surgery Department, San Pablo University, CEU, Madrid, Spain., D'Ovidio A; Sanchinarro University Hospital, General Surgery Department, San Pablo University, CEU, Madrid, Spain., Núñez-Alfonsel J; Instituto de Validación de la Eficiencia Clínica (IVEc) Fundación de Investigación HM Hospitales, Madrid, Spain., Plaza C; Sanchinarro University Hospital, General Surgery Department, San Pablo University, CEU, Madrid, Spain., Ielpo B; Sanchinarro University Hospital, General Surgery Department, San Pablo University, CEU, Madrid, Spain., Vicente E; Sanchinarro University Hospital, General Surgery Department, San Pablo University, CEU, Madrid, Spain. |
| المصدر: | Surgical technology international [Surg Technol Int] 2019 Nov 10; Vol. 35, pp. 92-99. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Universal Medical Press Country of Publication: United States NLM ID: 9604509 Publication Model: Print Cited Medium: Print ISSN: 1090-3941 (Print) Linking ISSN: 10903941 NLM ISO Abbreviation: Surg Technol Int Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: San Francisco, CA : Universal Medical Press Original Publication: [London] : Century Press, c1991- |
| مواضيع طبية MeSH: | Pancreatectomy* , Pancreatic Neoplasms*/blood supply , Pancreatic Neoplasms*/surgery, Humans ; Prognosis ; Retrospective Studies |
| مستخلص: | Introduction: Locally advanced pancreatic cancer (LAPC) is a highly malignant carcinoma with an extremely poor prognosis. Vascular venous invasion is a frequent finding in patients with pancreatic cancer. The aim of this study was to investigate the morbidity, mortality, and survival of patients with advanced pancreatic cancer. Methods: We retrospectively reviewed our experience of 65 consecutive pancreatic surgeries with venous resection for pancreatic cancer in three hospitals: Ramon y Cajal (Madrid, Spain) from 2002 to 2004, Monteprincipe University Hospital (Madrid, Spain) from 2005 to 2006 and Sanchinarro University Hospital (Madrid, Spain) from 2007 to December 2017. Prognostic factors were analyzed by the log-rank test and a multivariate proportional hazard regression analysis. Results: Major venous reconstruction was performed by primary lateral venorrhaphy in 11 patients (17%), primary end-to-end anastomosis in 46 (70.7%) and reconstruction with a Gore-Tex® patch (W.L. Gore & Associates, Inc., Flagstaff, AZ) in 8 (12.3%). In 58% of the patients, the pathological examination showed infiltration of the vascular specimen. About 85% of the procedures performed were R0. The perioperative morbidity rate with Dindo-Clavien classification = III was 21.5%. Tumor size and nodal status were the only prognostic variables, which significantly decreased survival by a multivariate analysis. Conclusions: Major vascular resection to achieve macroscopic tumor clearance can be performed safely with acceptable operative morbidity and mortality. Nevertheless, it is justified only in carefully selected cases. |
| تواريخ الأحداث: | Date Created: 20191106 Date Completed: 20191220 Latest Revision: 20200108 |
| رمز التحديث: | 20240628 |
| PMID: | 31687780 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1090-3941 |
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