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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Surgery 1/2015

The short- and long-term outcomes of radical antegrade modular pancreatosplenectomy for adenocarcinoma of the body and tail of the pancreas

Zeitschrift:
BMC Surgery > Ausgabe 1/2015
Autoren:
Masaaki Murakawa, Toru Aoyama, Masahiro Asari, Yusuke Katayama, Koichiro Yamaoku, Amane Kanazawa, Akio Higuchi, Manabu Shiozawa, Satoshi Kobayashi, Makoto Ueno, Manabu Morimoto, Naoto Yamamoto, Takaki Yoshikawa, Yasushi Rino, Munetaka Masuda, Soichiro Morinaga
Wichtige Hinweise
Masaaki Murakawa and Toru Aoyama contributed equally to this work.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

Our manuscript has 16 authors. Details of contributions by each author are as follows; M. Murakawa actively involved in this study especially in statistical design. Concept and clinical design were conducted by 2 surgeons (M. Murakawa and T. Aoyama). Acquisition of data was done by all physician. Interpretation of data, and drafting the article was done by M. Murakawa and T. Aoyama. Finally, this article was revised and approved by all 16 investigators. Thus, all 16 authors actively participated in this study.

Abstract

Background

Radical antegrade modular pancreatosplenectomy (RAMPS) is a relatively new modification of the standard distal pancreatosplenectomy. In this method, dissection proceeds from right-to-left to achieve negative posterior resection margins. However, short-term and long-term outcomes of RAMPS for pancreatic cancer have not yet been clarified. The aim of this study is to evaluate short-term and long-term outcomes in the patients who have undergone RAMPS.

Methods

Consecutive 49 patients were selected from the retrospective database of the Kanagawa Cancer Center from 2000 to 2014. Data from the operative notes, pathology reports, postoperative data, and outpatient data (recurrence and survival) were entered into the database.

Results

All patients were undergone anterior RAMPS. The median operation time was 278 min (range from 140 to 625 mins). The median blood loss in operation was 850 ml (range from 60 to 2790 ml). The overall incidence of morbidity was 51.4 % and the incidence of mortality was 0 %. Forty-one patients (83.7 %) had negative resection margins. The mean number of lymph nodes harvested was 15 and 27 patients had lymph node metastasis. After the median follow-up period was 41.1 months, 1-year and 3-year overall survival rates were 84.1 and 38.6 %, respectively. Median overall survival was 22.6 months.

Conclusions

The present study results suggested that RAMPS procedure might be safe and feasible without an increase in morbidity and morbidity and have survival benefit compared with standard DP.
Literatur
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