Cargando…
A New Surgical Technique of Pancreaticoduodenectomy with Splenic Artery Resection for Ductal Adenocarcinoma of the Pancreatic Head and/or Body Invading Splenic Artery: Impact of the Balance between Surgical Radicality and QOL to Avoid Total Pancreatectomy
For pancreatic ductal adenocarcinoma (PDAC) of the head and/or body invading the splenic artery (SA), we developed a new surgical technique of proximal subtotal pancreatectomy with splenic artery and vein resection, so-called pancreaticoduodenectomy with splenic artery resection (PD-SAR). We retrosp...
Autores principales: | , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi Publishing Corporation
2014
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4075002/ https://www.ncbi.nlm.nih.gov/pubmed/25013768 http://dx.doi.org/10.1155/2014/219038 |
_version_ | 1782323281497423872 |
---|---|
author | Desaki, Ryosuke Mizuno, Shugo Tanemura, Akihiro Kishiwada, Masashi Murata, Yasuhiro Azumi, Yoshinori Kuriyama, Naohisa Usui, Masanobu Sakurai, Hiroyuki Tabata, Masami Isaji, Shuji |
author_facet | Desaki, Ryosuke Mizuno, Shugo Tanemura, Akihiro Kishiwada, Masashi Murata, Yasuhiro Azumi, Yoshinori Kuriyama, Naohisa Usui, Masanobu Sakurai, Hiroyuki Tabata, Masami Isaji, Shuji |
author_sort | Desaki, Ryosuke |
collection | PubMed |
description | For pancreatic ductal adenocarcinoma (PDAC) of the head and/or body invading the splenic artery (SA), we developed a new surgical technique of proximal subtotal pancreatectomy with splenic artery and vein resection, so-called pancreaticoduodenectomy with splenic artery resection (PD-SAR). We retrospectively reviewed a total of 84 patients with curative intent pancreaticoduodenectomy (PD) for PDAC of the head and/or body. These 84 patients were classified into the two groups: conventional PD (n = 66) and PD-SAR (n = 18). Most patients were treated by preoperative chemoradiotherapy (CRT). Postoperative MDCT clearly demonstrated enhancement of the remnant pancreas at 1 and 6 months in all patients examined. Overall survival rates were very similar between PD and PD-SAR (3-year OS: 23.7% versus 23.1%, P = 0.538), despite the fact that the tumor size and the percentages of UICC-T4 determined before treatment were higher in PD-SAR. Total daily insulin dose was significantly higher in PD-SAR than in PD at 1 month, while showing no significant differences between the two groups thereafter. PD-SAR with preoperative CRT seems to be promising surgical strategy for PDAC of head and/or body with invasion of the splenic artery, in regard to the balance between operative radicality and postoperative QOL. |
format | Online Article Text |
id | pubmed-4075002 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Hindawi Publishing Corporation |
record_format | MEDLINE/PubMed |
spelling | pubmed-40750022014-07-10 A New Surgical Technique of Pancreaticoduodenectomy with Splenic Artery Resection for Ductal Adenocarcinoma of the Pancreatic Head and/or Body Invading Splenic Artery: Impact of the Balance between Surgical Radicality and QOL to Avoid Total Pancreatectomy Desaki, Ryosuke Mizuno, Shugo Tanemura, Akihiro Kishiwada, Masashi Murata, Yasuhiro Azumi, Yoshinori Kuriyama, Naohisa Usui, Masanobu Sakurai, Hiroyuki Tabata, Masami Isaji, Shuji Biomed Res Int Clinical Study For pancreatic ductal adenocarcinoma (PDAC) of the head and/or body invading the splenic artery (SA), we developed a new surgical technique of proximal subtotal pancreatectomy with splenic artery and vein resection, so-called pancreaticoduodenectomy with splenic artery resection (PD-SAR). We retrospectively reviewed a total of 84 patients with curative intent pancreaticoduodenectomy (PD) for PDAC of the head and/or body. These 84 patients were classified into the two groups: conventional PD (n = 66) and PD-SAR (n = 18). Most patients were treated by preoperative chemoradiotherapy (CRT). Postoperative MDCT clearly demonstrated enhancement of the remnant pancreas at 1 and 6 months in all patients examined. Overall survival rates were very similar between PD and PD-SAR (3-year OS: 23.7% versus 23.1%, P = 0.538), despite the fact that the tumor size and the percentages of UICC-T4 determined before treatment were higher in PD-SAR. Total daily insulin dose was significantly higher in PD-SAR than in PD at 1 month, while showing no significant differences between the two groups thereafter. PD-SAR with preoperative CRT seems to be promising surgical strategy for PDAC of head and/or body with invasion of the splenic artery, in regard to the balance between operative radicality and postoperative QOL. Hindawi Publishing Corporation 2014 2014-06-12 /pmc/articles/PMC4075002/ /pubmed/25013768 http://dx.doi.org/10.1155/2014/219038 Text en Copyright © 2014 Ryosuke Desaki et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Study Desaki, Ryosuke Mizuno, Shugo Tanemura, Akihiro Kishiwada, Masashi Murata, Yasuhiro Azumi, Yoshinori Kuriyama, Naohisa Usui, Masanobu Sakurai, Hiroyuki Tabata, Masami Isaji, Shuji A New Surgical Technique of Pancreaticoduodenectomy with Splenic Artery Resection for Ductal Adenocarcinoma of the Pancreatic Head and/or Body Invading Splenic Artery: Impact of the Balance between Surgical Radicality and QOL to Avoid Total Pancreatectomy |
title | A New Surgical Technique of Pancreaticoduodenectomy with Splenic Artery Resection for Ductal Adenocarcinoma of the Pancreatic Head and/or Body Invading Splenic Artery: Impact of the Balance between Surgical Radicality and QOL to Avoid Total Pancreatectomy |
title_full | A New Surgical Technique of Pancreaticoduodenectomy with Splenic Artery Resection for Ductal Adenocarcinoma of the Pancreatic Head and/or Body Invading Splenic Artery: Impact of the Balance between Surgical Radicality and QOL to Avoid Total Pancreatectomy |
title_fullStr | A New Surgical Technique of Pancreaticoduodenectomy with Splenic Artery Resection for Ductal Adenocarcinoma of the Pancreatic Head and/or Body Invading Splenic Artery: Impact of the Balance between Surgical Radicality and QOL to Avoid Total Pancreatectomy |
title_full_unstemmed | A New Surgical Technique of Pancreaticoduodenectomy with Splenic Artery Resection for Ductal Adenocarcinoma of the Pancreatic Head and/or Body Invading Splenic Artery: Impact of the Balance between Surgical Radicality and QOL to Avoid Total Pancreatectomy |
title_short | A New Surgical Technique of Pancreaticoduodenectomy with Splenic Artery Resection for Ductal Adenocarcinoma of the Pancreatic Head and/or Body Invading Splenic Artery: Impact of the Balance between Surgical Radicality and QOL to Avoid Total Pancreatectomy |
title_sort | new surgical technique of pancreaticoduodenectomy with splenic artery resection for ductal adenocarcinoma of the pancreatic head and/or body invading splenic artery: impact of the balance between surgical radicality and qol to avoid total pancreatectomy |
topic | Clinical Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4075002/ https://www.ncbi.nlm.nih.gov/pubmed/25013768 http://dx.doi.org/10.1155/2014/219038 |
work_keys_str_mv | AT desakiryosuke anewsurgicaltechniqueofpancreaticoduodenectomywithsplenicarteryresectionforductaladenocarcinomaofthepancreaticheadandorbodyinvadingsplenicarteryimpactofthebalancebetweensurgicalradicalityandqoltoavoidtotalpancreatectomy AT mizunoshugo anewsurgicaltechniqueofpancreaticoduodenectomywithsplenicarteryresectionforductaladenocarcinomaofthepancreaticheadandorbodyinvadingsplenicarteryimpactofthebalancebetweensurgicalradicalityandqoltoavoidtotalpancreatectomy AT tanemuraakihiro anewsurgicaltechniqueofpancreaticoduodenectomywithsplenicarteryresectionforductaladenocarcinomaofthepancreaticheadandorbodyinvadingsplenicarteryimpactofthebalancebetweensurgicalradicalityandqoltoavoidtotalpancreatectomy AT kishiwadamasashi anewsurgicaltechniqueofpancreaticoduodenectomywithsplenicarteryresectionforductaladenocarcinomaofthepancreaticheadandorbodyinvadingsplenicarteryimpactofthebalancebetweensurgicalradicalityandqoltoavoidtotalpancreatectomy AT muratayasuhiro anewsurgicaltechniqueofpancreaticoduodenectomywithsplenicarteryresectionforductaladenocarcinomaofthepancreaticheadandorbodyinvadingsplenicarteryimpactofthebalancebetweensurgicalradicalityandqoltoavoidtotalpancreatectomy AT azumiyoshinori anewsurgicaltechniqueofpancreaticoduodenectomywithsplenicarteryresectionforductaladenocarcinomaofthepancreaticheadandorbodyinvadingsplenicarteryimpactofthebalancebetweensurgicalradicalityandqoltoavoidtotalpancreatectomy AT kuriyamanaohisa anewsurgicaltechniqueofpancreaticoduodenectomywithsplenicarteryresectionforductaladenocarcinomaofthepancreaticheadandorbodyinvadingsplenicarteryimpactofthebalancebetweensurgicalradicalityandqoltoavoidtotalpancreatectomy AT usuimasanobu anewsurgicaltechniqueofpancreaticoduodenectomywithsplenicarteryresectionforductaladenocarcinomaofthepancreaticheadandorbodyinvadingsplenicarteryimpactofthebalancebetweensurgicalradicalityandqoltoavoidtotalpancreatectomy AT sakuraihiroyuki anewsurgicaltechniqueofpancreaticoduodenectomywithsplenicarteryresectionforductaladenocarcinomaofthepancreaticheadandorbodyinvadingsplenicarteryimpactofthebalancebetweensurgicalradicalityandqoltoavoidtotalpancreatectomy AT tabatamasami anewsurgicaltechniqueofpancreaticoduodenectomywithsplenicarteryresectionforductaladenocarcinomaofthepancreaticheadandorbodyinvadingsplenicarteryimpactofthebalancebetweensurgicalradicalityandqoltoavoidtotalpancreatectomy AT isajishuji anewsurgicaltechniqueofpancreaticoduodenectomywithsplenicarteryresectionforductaladenocarcinomaofthepancreaticheadandorbodyinvadingsplenicarteryimpactofthebalancebetweensurgicalradicalityandqoltoavoidtotalpancreatectomy AT desakiryosuke newsurgicaltechniqueofpancreaticoduodenectomywithsplenicarteryresectionforductaladenocarcinomaofthepancreaticheadandorbodyinvadingsplenicarteryimpactofthebalancebetweensurgicalradicalityandqoltoavoidtotalpancreatectomy AT mizunoshugo newsurgicaltechniqueofpancreaticoduodenectomywithsplenicarteryresectionforductaladenocarcinomaofthepancreaticheadandorbodyinvadingsplenicarteryimpactofthebalancebetweensurgicalradicalityandqoltoavoidtotalpancreatectomy AT tanemuraakihiro newsurgicaltechniqueofpancreaticoduodenectomywithsplenicarteryresectionforductaladenocarcinomaofthepancreaticheadandorbodyinvadingsplenicarteryimpactofthebalancebetweensurgicalradicalityandqoltoavoidtotalpancreatectomy AT kishiwadamasashi newsurgicaltechniqueofpancreaticoduodenectomywithsplenicarteryresectionforductaladenocarcinomaofthepancreaticheadandorbodyinvadingsplenicarteryimpactofthebalancebetweensurgicalradicalityandqoltoavoidtotalpancreatectomy AT muratayasuhiro newsurgicaltechniqueofpancreaticoduodenectomywithsplenicarteryresectionforductaladenocarcinomaofthepancreaticheadandorbodyinvadingsplenicarteryimpactofthebalancebetweensurgicalradicalityandqoltoavoidtotalpancreatectomy AT azumiyoshinori newsurgicaltechniqueofpancreaticoduodenectomywithsplenicarteryresectionforductaladenocarcinomaofthepancreaticheadandorbodyinvadingsplenicarteryimpactofthebalancebetweensurgicalradicalityandqoltoavoidtotalpancreatectomy AT kuriyamanaohisa newsurgicaltechniqueofpancreaticoduodenectomywithsplenicarteryresectionforductaladenocarcinomaofthepancreaticheadandorbodyinvadingsplenicarteryimpactofthebalancebetweensurgicalradicalityandqoltoavoidtotalpancreatectomy AT usuimasanobu newsurgicaltechniqueofpancreaticoduodenectomywithsplenicarteryresectionforductaladenocarcinomaofthepancreaticheadandorbodyinvadingsplenicarteryimpactofthebalancebetweensurgicalradicalityandqoltoavoidtotalpancreatectomy AT sakuraihiroyuki newsurgicaltechniqueofpancreaticoduodenectomywithsplenicarteryresectionforductaladenocarcinomaofthepancreaticheadandorbodyinvadingsplenicarteryimpactofthebalancebetweensurgicalradicalityandqoltoavoidtotalpancreatectomy AT tabatamasami newsurgicaltechniqueofpancreaticoduodenectomywithsplenicarteryresectionforductaladenocarcinomaofthepancreaticheadandorbodyinvadingsplenicarteryimpactofthebalancebetweensurgicalradicalityandqoltoavoidtotalpancreatectomy AT isajishuji newsurgicaltechniqueofpancreaticoduodenectomywithsplenicarteryresectionforductaladenocarcinomaofthepancreaticheadandorbodyinvadingsplenicarteryimpactofthebalancebetweensurgicalradicalityandqoltoavoidtotalpancreatectomy |