Buchumschlag

Arterial resection in pancreatic cancer surgery: effective after a learning curve

Objective: - To investigate the perioperative and oncologic long-term outcomes of patients with LAPC after surgical resection at a high-volume center for pancreatic surgery. - Background: - The role of surgery in LAPC with arterial involvement is controversial. - Me...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Hauptverfasser: Loos, Martin (VerfasserIn) , Kester, Tobias (VerfasserIn) , Klaiber, Ulla (VerfasserIn) , Mihaljevic, André Leopold (VerfasserIn) , Mehrabi, Arianeb (VerfasserIn) , Müller, Beat P. (VerfasserIn) , Diener, Markus K. (VerfasserIn) , Schneider, Martin (VerfasserIn) , Berchtold, Christoph (VerfasserIn) , Hinz, Ulf (VerfasserIn) , Feißt, Manuel (VerfasserIn) , Strobel, Oliver (VerfasserIn) , Hackert, Thilo (VerfasserIn) , Büchler, Markus W. (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 2022
In: Annals of surgery
Year: 2022, Jahrgang: 275, Heft: 4, Pages: 759-768
ISSN:1528-1140
DOI:10.1097/SLA.0000000000004054
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1097/SLA.0000000000004054
Verlag, lizenzpflichtig, Volltext: https://journals.lww.com/annalsofsurgery/Fulltext/2022/04000/Arterial_Resection_in_Pancreatic_Cancer_Surgery_.21.aspx
Volltext
Verfasserangaben:Martin Loos, MD, Tobias Kester, Ulla Klaiber, MD, Andre L. Mihaljevic, MD, MSc, Arianeb Mehrabi, MD, Beat M. Müller-Stich, MD, Markus K. Diener, MD, Martin A. Schneider, MD, Christoph Berchtold, MD, Ulf Hinz, MSc, Manuel Feisst, MSc, Oliver Strobel, MD, Thilo Hackert, MD, and Markus W. Büchler, MD
Beschreibung
Zusammenfassung:Objective: - To investigate the perioperative and oncologic long-term outcomes of patients with LAPC after surgical resection at a high-volume center for pancreatic surgery. - Background: - The role of surgery in LAPC with arterial involvement is controversial. - Methods: - We analyzed 385 consecutive patients undergoing PAR (n = 195) or PAD (n = 190) of the encased artery for LAPC between January 1, 2003 and April 30, 2019. - Results: - There were 183 total pancreatectomies, 113 partial pancreatoduodenectomies, 79 distal pancreatectomies, and 10 resections for tumor recurrences, including 121 multivisceral resections and 171 venous resections. Forty-three patients (11.4%) had resectable oligometastatic disease. All of the 190 patients undergoing PAD (100%) and 95 of the 195 patients undergoing PAR (48.7%) received neoadjuvant chemotherapy. The R0 (circumferential resection margin negative) resection rate was 28%. The median hospital stay was 15 days (range: 3-236). The median survival after surgery for LAPC was 20.1 months and the overall 5-year survival rate 12.5%. In-hospital mortality was 8.8% for the entire patient cohort (n = 385). With increasing case load and growing expertise, there was a significant reduction of in-hospital mortality to 4.8% (n = 186) after 2013 (P = 0.005). The learning curve of experienced pancreatic surgeons for PAR was 15 such procedures. - Conclusion: - Our data demonstrate that an arterial surgical approach is effective in LAPC with promising long-term survival. PAD after neoadjuvant treatment is safe. PAR is a technically demanding procedure and requires a high level of expertise.
Beschreibung:Date: Jun 12, 2020
Gesehen am 01.04.2022
Beschreibung:Online Resource
ISSN:1528-1140
DOI:10.1097/SLA.0000000000004054

Ähnliche Einträge