Distal pancreatectomy with multivisceral resection : A retrospective multicenter study - Case series
Copyright © 2020 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved..
BACKGROUND: Multivisceral resection (MVR) is sometimes necessary to achieve disease-free margins in cancer surgery. In certain patients with pancreatic tumors that invade neighboring organs these must be removed to perform an appropriate oncological surgery. In addition, there is an increasing need to perform resections of other organs like liver not directly invaded by the tumor but which require synchronous removal. The results of MVR in pancreatic surgery are controversial.
MATERIAL AND METHODS: A distal pancreatectomy retrospective multicenter observational study using prospectively compiled data carried out at seven HPB Units. The period study was January 2008 to December 2018. We excluded DP with celiac trunk resection.
RESULTS: 435 DP were performed. In 62 (14.25%) an extra organ was resected (82 organs). Comparison of the preoperative data of MVR and non-MVR patients showed that patients with MVR had lower BMI, higher ASA and larger tumor size. In the MVR group, the approach was mostly laparotomic and spleen preservation was performed only in 8% of the cases, Blood loss and the percentage of intraoperative transfusion were higher in MVR group. Major morbidity rates (Clavien > IIIa) and mortality (0.8vs.4.8%) were higher in the MVR group. Pancreatic fistula rates were practically the same in both groups. Mean hospital stay was twice as long in the MVR group and the readmission rate was higher in the MVR group. Histology study confirmed a much higher rate of malignant tumors in MVR group.
CONCLUSIONS: In order to obtain free margins or treat pathologies in several organs we think that DP + MVR is a feasible technique in selected patients; the results obtained are not as good as those of DP without MVR but are acceptable nonetheless. CLINICALTRIALS.
GOV IDENTIFIER: NCT04317352.
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:82 |
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| Enthalten in: |
International journal of surgery (London, England) - 82(2020) vom: 15. Okt., Seite 123-129 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ramia, Jose M [VerfasserIn] |
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| Links: |
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| Themen: |
Cancer |
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| Anmerkungen: |
Date Completed 11.02.2021 Date Revised 19.02.2021 published: Print-Electronic ClinicalTrials.gov: NCT04317352 CommentIn: Int J Surg. 2020 Nov;83:180-181. - PMID 32992026 Citation Status MEDLINE |
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| doi: |
10.1016/j.ijsu.2020.08.024 |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
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| 100 | 1 | |a Ramia, Jose M |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Distal pancreatectomy with multivisceral resection |b A retrospective multicenter study - Case series |
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| 500 | |a Date Completed 11.02.2021 | ||
| 500 | |a Date Revised 19.02.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a ClinicalTrials.gov: NCT04317352 | ||
| 500 | |a CommentIn: Int J Surg. 2020 Nov;83:180-181. - PMID 32992026 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved. | ||
| 520 | |a BACKGROUND: Multivisceral resection (MVR) is sometimes necessary to achieve disease-free margins in cancer surgery. In certain patients with pancreatic tumors that invade neighboring organs these must be removed to perform an appropriate oncological surgery. In addition, there is an increasing need to perform resections of other organs like liver not directly invaded by the tumor but which require synchronous removal. The results of MVR in pancreatic surgery are controversial | ||
| 520 | |a MATERIAL AND METHODS: A distal pancreatectomy retrospective multicenter observational study using prospectively compiled data carried out at seven HPB Units. The period study was January 2008 to December 2018. We excluded DP with celiac trunk resection | ||
| 520 | |a RESULTS: 435 DP were performed. In 62 (14.25%) an extra organ was resected (82 organs). Comparison of the preoperative data of MVR and non-MVR patients showed that patients with MVR had lower BMI, higher ASA and larger tumor size. In the MVR group, the approach was mostly laparotomic and spleen preservation was performed only in 8% of the cases, Blood loss and the percentage of intraoperative transfusion were higher in MVR group. Major morbidity rates (Clavien > IIIa) and mortality (0.8vs.4.8%) were higher in the MVR group. Pancreatic fistula rates were practically the same in both groups. Mean hospital stay was twice as long in the MVR group and the readmission rate was higher in the MVR group. Histology study confirmed a much higher rate of malignant tumors in MVR group | ||
| 520 | |a CONCLUSIONS: In order to obtain free margins or treat pathologies in several organs we think that DP + MVR is a feasible technique in selected patients; the results obtained are not as good as those of DP without MVR but are acceptable nonetheless. CLINICALTRIALS | ||
| 520 | |a GOV IDENTIFIER: NCT04317352 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Cancer | |
| 650 | 4 | |a Distal pancreatectomy | |
| 650 | 4 | |a Multivisceral | |
| 650 | 4 | |a Pancreas | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a Surgery | |
| 700 | 1 | |a Del Río-Martín, Juan V |e verfasserin |4 aut | |
| 700 | 1 | |a Blanco-Fernández, Gerardo |e verfasserin |4 aut | |
| 700 | 1 | |a Cantalejo-Díaz, Miguel |e verfasserin |4 aut | |
| 700 | 1 | |a Rotellar-Sastre, Fernando |e verfasserin |4 aut | |
| 700 | 1 | |a Sabater-Orti, Luis |e verfasserin |4 aut | |
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| 700 | 1 | |a Manuel-Vázquez, Alba |e verfasserin |4 aut | |
| 700 | 1 | |a Hernández-Rivera, Pedro J |e verfasserin |4 aut | |
| 700 | 1 | |a Jaén-Torrejimeno, Isabel |e verfasserin |4 aut | |
| 700 | 1 | |a Kalviainen-Mejia, Helga K |e verfasserin |4 aut | |
| 700 | 1 | |a Esteban-Gordillo, Sara |e verfasserin |4 aut | |
| 700 | 1 | |a Muñoz-Forner, Elena |e verfasserin |4 aut | |
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| 700 | 1 | |a Longoria-Dubocq, Texell |e verfasserin |4 aut | |
| 700 | 1 | |a De Armas-Conde, Noelia |e verfasserin |4 aut | |
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| 700 | 1 | |a Garcés-Albir, Marina |e verfasserin |4 aut | |
| 700 | 1 | |a Serradilla-Martín, Mario |e verfasserin |4 aut | |
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