|
Back to 2016 Annual Meeting
The Surgical Impact of Mesenteric Approach for Borderline Resectable Pancreatic Cancer
Hiroki Yamaue*, Manabu Kawai, Seiko Hirono, Ken-ichi Okada, Motoki Miyazawa, Atsushi Shimizu, Yuji Kitahata
Second Department of Surgery, Wakayama Medical University School of Medicine, Wakayama, Japan
Background: Mesenteric approach makes it easy to determine the resectability at the beginning of the operation. Moreover, this approach allows better exposure and dissection of the posterior fat tissues of SMA-SMV. However, there is currently no evidence whether the mesenteric approach and/or left posterior approach have clinical and survival benefits for BR pancreatic head cancer.
Aim: The aim of this study is to evaluate the impact of mesenteric approach that can be used to increase the R0 rates and survival benefits for borderline resectable (BR) pancreatic head cancer with abutment to superior mesenteric artery (SMA). Method: Between 2000 and 2014, 212 patients underwent pancreatic surgery for pancreatic head cancer. Of them, 71 patients with BR pancreatic head cancer with abutment to SMA were enrolled for this study. Twenty-one patients of 71 patients with BR pancreatic head cancer with abutment to SMA underwent mesenteric approach between 2011and 2014.
Results: R0 rate in patients with mesenteric approach was 85.7% and R0 rate in patients without mesenteric approach was 76%. Mesenteric approach significantly reduced intraoperative bleeding compared to no mesenteric approach (535ml vs.912ml, P=0.026). There were no significant differences between patients with and without mesenteric approach concerning to postoperative complications. Median survival time in patients with mesenteric approach was 20.3 months compared to 10.2 months in patients without mesenteric approach (P=0.064).
Conclusion: The mesenteric approach is a feasible procedure to obtain R0 rates. The development of mesenteric approach may be necessary to improve the survival of BR pancreatic head cancer.
Back to 2016 Annual Meeting
|
