Krishna Kotecha, Juanita Chui, Kai Brown, Anubhav Mittal, Jaswinder Samra
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引用次数: 0
Abstract
Background: Pancreatic adenocarcinoma has a predisposition to invade the neural tissue surrounding the superior mesenteric artery (SMA). Before the advent of neoadjuvant chemotherapy (NAC), any invasion of this tissue was often considered as unresectable disease. Currently, patients who respond favourably to NAC have potentially resectable disease. There is debate over the exact technique of removing this shell of tumour tissue surrounding the SMA, and whether it is comparable to arterial resection and reconstruction.
Methods: We describe a technique of en bloc arterial divestment in which an endovascular stapler combined with sharp dissection is used to divide the shell of periadventitial SMA tissue.
Conclusions: In patients with locally advanced disease, the technique of arterial divestment can be safely performed where the tumour is not invading below the external elastic lamina. This allows complete tumour resection without incurring the higher morbidity and mortality associated with SMA resection.
期刊介绍：
The Journal of Surgical Oncology offers peer-reviewed, original papers in the field of surgical oncology and broadly related surgical sciences, including reports on experimental and laboratory studies. As an international journal, the editors encourage participation from leading surgeons around the world. The JSO is the representative journal for the World Federation of Surgical Oncology Societies. Publishing 16 issues in 2 volumes each year, the journal accepts Research Articles, in-depth Reviews of timely interest, Letters to the Editor, and invited Editorials. Guest Editors from the JSO Editorial Board oversee multiple special Seminars issues each year. These Seminars include multifaceted Reviews on a particular topic or current issue in surgical oncology, which are invited from experts in the field.
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