Pancreatectomy With Artery


Journal

Anticancer research
ISSN: 1791-7530
Titre abrégé: Anticancer Res
Pays: Greece
ID NLM: 8102988

Informations de publication

Date de publication:
Jan 2022
Historique:
received: 07 10 2021
revised: 27 10 2021
accepted: 29 11 2021
entrez: 31 12 2021
pubmed: 1 1 2022
medline: 14 1 2022
Statut: ppublish

Résumé

The potential benefits of pancreatectomy with major arterial resection have been studied in the past, but findings remain controversial. Pancreatic neck/body cancer (PNBC) involving arteries frequently requires combined resection of the pancreas, artery and portal vein. Nine prospectively-registered consecutive patients with PNBC were enrolled, all underwent pancreatoduodenectomy with common hepatic artery en-bloc resection (PD-CHAR). We investigated the safety of PD-CHAR by blood flow evaluation with intraoperative indocyanine green fluorescence imaging in reconstructed vessels/organs. Among patients who underwent PD-CHAR, there was no severe morbidity. Artery/portal vein combined resection and reconstruction was performed in all patients. Four (44%) patients had pathological positivity for cancer cell invasion into the nerve plexus of artery at the site of radiographic artery involvement, although one (11%) was diagnosed with pathological artery involvement. PD-CHAR following neoadjuvant therapy might be feasible for PNBC without severe postoperative complications. Survival benefits in PNBC should be confirmed in further studies.

Sections du résumé

BACKGROUND/AIM OBJECTIVE
The potential benefits of pancreatectomy with major arterial resection have been studied in the past, but findings remain controversial. Pancreatic neck/body cancer (PNBC) involving arteries frequently requires combined resection of the pancreas, artery and portal vein.
PATIENTS AND METHODS METHODS
Nine prospectively-registered consecutive patients with PNBC were enrolled, all underwent pancreatoduodenectomy with common hepatic artery en-bloc resection (PD-CHAR). We investigated the safety of PD-CHAR by blood flow evaluation with intraoperative indocyanine green fluorescence imaging in reconstructed vessels/organs.
RESULTS RESULTS
Among patients who underwent PD-CHAR, there was no severe morbidity. Artery/portal vein combined resection and reconstruction was performed in all patients. Four (44%) patients had pathological positivity for cancer cell invasion into the nerve plexus of artery at the site of radiographic artery involvement, although one (11%) was diagnosed with pathological artery involvement.
CONCLUSION CONCLUSIONS
PD-CHAR following neoadjuvant therapy might be feasible for PNBC without severe postoperative complications. Survival benefits in PNBC should be confirmed in further studies.

Identifiants

pubmed: 34969728
pii: 42/1/217
doi: 10.21873/anticanres.15476
doi:

Substances chimiques

Indocyanine Green IX6J1063HV

Types de publication

Clinical Trial Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

217-227

Informations de copyright

Copyright © 2022 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Auteurs

Ken-Ichi Okada (KI)

Second Department of Surgery, Wakayama Medical University, Wakayama, Japan.

Manabu Kawai (M)

Second Department of Surgery, Wakayama Medical University, Wakayama, Japan kawai@wakayama-med.ac.jp.

Seiko Hirono (S)

Second Department of Surgery, Wakayama Medical University, Wakayama, Japan.

Shinya Hayami (S)

Second Department of Surgery, Wakayama Medical University, Wakayama, Japan.

Motoki Miyazawa (M)

Second Department of Surgery, Wakayama Medical University, Wakayama, Japan.

Yuji Kitahata (Y)

Second Department of Surgery, Wakayama Medical University, Wakayama, Japan.

Masaki Ueno (M)

Second Department of Surgery, Wakayama Medical University, Wakayama, Japan.

Ryohei Kobayashi (R)

Second Department of Surgery, Wakayama Medical University, Wakayama, Japan.

Atsushi Miyamoto (A)

Second Department of Surgery, Wakayama Medical University, Wakayama, Japan.

Yoshitaka Wada (Y)

Department of Plastic Surgery, Wakayama Medical University, Wakayama, Japan.

Shinichi Asamura (S)

Department of Plastic Surgery, Wakayama Medical University, Wakayama, Japan.

Hiroki Yamaue (H)

Second Department of Surgery, Wakayama Medical University, Wakayama, Japan.

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Classifications MeSH