Postoperative Outcomes of Tangential
Adenocarcinoma
/ pathology
Adult
Aged
Aged, 80 and over
Carcinoma, Pancreatic Ductal
/ pathology
Female
Follow-Up Studies
Humans
Male
Margins of Excision
Mesenteric Veins
/ pathology
Middle Aged
Pancreatic Neoplasms
/ pathology
Pancreaticoduodenectomy
/ mortality
Portal Vein
/ pathology
Postoperative Complications
Prognosis
Plastic Surgery Procedures
/ mortality
Retrospective Studies
Survival Rate
Vascular Surgical Procedures
/ mortality
30-day mortality
Pancreatic ductal adenocarcinoma
morbidity
pancreatoduodenectomy
perioperative outcomes
portal venous resection
Journal
Anticancer research
ISSN: 1791-7530
Titre abrégé: Anticancer Res
Pays: Greece
ID NLM: 8102988
Informations de publication
Date de publication:
Oct 2021
Oct 2021
Historique:
received:
04
08
2021
revised:
23
08
2021
accepted:
24
08
2021
entrez:
1
10
2021
pubmed:
2
10
2021
medline:
12
10
2021
Statut:
ppublish
Résumé
The impact of venous resections and reconstruction techniques on morbidity after surgery for pancreatic cancer (PDAC) remains controversial. A total of 143 patients receiving pancreatoduodenectomy (PD) for PDAC between 2013 and 2018 were identified from a prospective database. Morbidity and mortality after PD with tangential resection versus end-to-end reconstruction were assessed. Fifty-two of 143 (36.4%) patients underwent PD with portal venous resection (PVR), which was associated with longer operation times [398 (standard error (SE) 12.01) vs. 306 (SE 13.09) min, p<0.001]. PVR was associated with longer intensive-care-unit stay (6.3 vs. 3.8 days, p=0.054); morbidity (Clavien-Dindo classification (CDC) grade IIIa-V 45.8% vs. 35.8%, p=0.279) and 30-day mortality (4.1% vs. 4.2%, p>0.99) were not different. Tangential venous resection was associated with similar CDC grade IIIa-IV (42.9% vs. 50.0%, p=0.781) and 30-day mortality rates (3.5% vs. 4.1%, p=0.538) as segmental resection and end-to-end venous reconstruction. Both tangential and segmental PVR appear feasible and can be safely performed to achieve negative resection margins.
Sections du résumé
BACKGROUND/AIM
OBJECTIVE
The impact of venous resections and reconstruction techniques on morbidity after surgery for pancreatic cancer (PDAC) remains controversial.
PATIENTS AND METHODS
METHODS
A total of 143 patients receiving pancreatoduodenectomy (PD) for PDAC between 2013 and 2018 were identified from a prospective database. Morbidity and mortality after PD with tangential resection versus end-to-end reconstruction were assessed.
RESULTS
RESULTS
Fifty-two of 143 (36.4%) patients underwent PD with portal venous resection (PVR), which was associated with longer operation times [398 (standard error (SE) 12.01) vs. 306 (SE 13.09) min, p<0.001]. PVR was associated with longer intensive-care-unit stay (6.3 vs. 3.8 days, p=0.054); morbidity (Clavien-Dindo classification (CDC) grade IIIa-V 45.8% vs. 35.8%, p=0.279) and 30-day mortality (4.1% vs. 4.2%, p>0.99) were not different. Tangential venous resection was associated with similar CDC grade IIIa-IV (42.9% vs. 50.0%, p=0.781) and 30-day mortality rates (3.5% vs. 4.1%, p=0.538) as segmental resection and end-to-end venous reconstruction.
CONCLUSION
CONCLUSIONS
Both tangential and segmental PVR appear feasible and can be safely performed to achieve negative resection margins.
Identifiants
pubmed: 34593463
pii: 41/10/5123
doi: 10.21873/anticanres.15329
doi:
Types de publication
Clinical Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
5123-5130Informations de copyright
Copyright © 2021 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.