Postoperative Outcomes of Tangential versus Segmental Resection and End-to-end Reconstruction of the Superior Mesenterico-Portal Vein During Pancreatoduodenectomy for Pancreatic Adenocarcinoma: A Single-Center Experience

被引:2
作者
Lapshyn, Hryhoriy [1 ]
Schulte, Theresa [1 ]
Petruch, Natalie [1 ]
Petrova, Ekaterina [1 ]
Honselmann, Kim [1 ]
Deichmann, Steffen [1 ]
Braun, Ruediger [1 ]
Kulemann, Birte [1 ]
Hoeppner, Jens [1 ]
Rades, Dirk [2 ]
Keck, Tobias [1 ]
Wellner, Ulrich F. [1 ]
Bausch, Dirk [1 ,3 ]
Bolm, Louisa [1 ]
机构
[1] Univ Hosp Schleswig Holstein UKSH, Dept Surg, Campus Lubeck, Lubeck, Germany
[2] Univ Hosp Schleswig Holstein UKSH, Dept Radiat Oncol, Campus Lubeck, Lubeck, Germany
[3] Ruhr Univ Bochum, Marien Hosp Herne, Dept Surg, Univ Hosp, Herne, Germany
关键词
Pancreatic ductal adenocarcinoma; pancreatoduodenectomy; portal venous resection; perioperative outcomes; morbidity; 30-day mortality; INTERNATIONAL STUDY-GROUP; MARGIN-STATUS; VASCULAR RESECTION; ARTERIAL RESECTION; PROGNOSTIC-FACTORS; VENOUS RESECTION; CANCER; SURVIVAL; SURGERY; FISTULA;
D O I
10.21873/anticanres.15329
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background/Aim: The impact of venous resections and reconstruction techniques on morbidity after surgery for pancreatic cancer (PDAC) remains controversial. Patients and 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: 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: Both tangential and segmental PVR appear feasible and can be safely performed to achieve negative resection margins.
引用
收藏
页码:5123 / 5130
页数:8
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