Annals of Surgical Treatment and Research最新文献

{"title":"Lateral pelvic lymph node dissection based on nodal response to neoadjuvant chemoradiotherapy in mid/low rectal cancer: a retrospective comparative cohort study.","authors":"Tae-Gyun Lee, Duck-Woo Kim, Hong-Min Ahn, Hye-Rim Shin, Mi Jeong Choi, Min Hyeong Jo, Heung-Kwon Oh, Sung-Bum Kang","doi":"10.4174/astr.2025.108.6.333","DOIUrl":"10.4174/astr.2025.108.6.333","url":null,"abstract":"<p><strong>Purpose: </strong>Total mesorectal excision (TME) without lateral pelvic lymph node (LPN) dissection (LPND) is feasible in patients with mid/low rectal cancer showing a reduction in LPN size to ≤5 mm following neoadjuvant chemoradiotherapy (nCRT). We aimed to evaluate the clinical outcomes of selective LPNDs based on these criteria.</p><p><strong>Methods: </strong>Patients with mid/low rectal cancer and LPNs >5 mm before nCRT were included and classified based on nCRT response (post-nCRT LPN size ≤5 mm [responsive] <i>vs.</i> >5 mm [persistent]) and surgical procedure (TME alone <i>vs.</i> TME + LPND). In the responsive group, LPND was selectively performed only if morphologic predictors of LPN metastasis were present. Clinical outcomes were analyzed across subgroups.</p><p><strong>Results: </strong>Of 122 patients, 82 were in the responsive group. Within this group, 61 underwent TME alone and 21 underwent TME + LPND. No locoregional recurrence was observed in either subgroup of the responsive group, with similar systemic metastasis rates (13.1% <i>vs.</i> 14.3%, P > 0.99). The TME alone subgroup showed significantly smaller post-nCRT LPN sizes (1.7 ± 2.1 mm <i>vs.</i> 3.9 ± 1.8 mm, P < 0.001) and lower ycN positivity rates (31.1% <i>vs.</i> 71.4%, P = 0.001).</p><p><strong>Conclusion: </strong>Selective LPND based on post-nCRT LPN size ≤5 mm and the absence of morphologic predictors of metastasis may serve as a feasible option for managing mid/low rectal cancer with enlarged LPNs, thereby optimizing local control and reducing unnecessary surgeries.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"108 6","pages":"333-344"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of pancreas transplantation over two decades: a single-center retrospective cohort study.","authors":"Jiyoung Shin, Hye Young Woo, Eun-Ah Jo, Ara Cho, Ahram Han, Sanghyun Ahn, Sangil Min, Jongwon Ha","doi":"10.4174/astr.2025.108.5.271","DOIUrl":"https://doi.org/10.4174/astr.2025.108.5.271","url":null,"abstract":"<p><strong>Purpose: </strong>Pancreas transplantation (PT) is a definitive treatment for diabetes mellitus (DM), restoring endogenous insulin secretion and improving glycemic control. Despite its efficacy, PT is less common in South Korea compared to Western nations. This study aims to report the clinical outcomes of PT over 2 decades at a single center, focusing on surgical techniques, complications, and graft survival.</p><p><strong>Methods: </strong>A retrospective analysis of 69 PT recipients at Seoul National University Hospital between January 2002 and December 2023 was conducted. Data on recipient and donor demographics, surgical details, immunosuppressive regimens, and graft outcomes were collected. Graft survival was evaluated using Kaplan-Meier analysis, with subgroup comparisons using the log-rank test. Graft failure was defined as graft removal, PT re-registration, insulin dependence exceeding 0.5 units/kg/day for more than 90 days, or patient death.</p><p><strong>Results: </strong>Among the 69 recipients, 50 (72.5%) had type 1 DM, and 18 (26.1%) had type 2 DM. Simultaneous pancreas-kidney (SPK) transplantations comprised 84.1% (n = 58), and pancreas-after-kidney (PAK) transplantations accounted for 10.1%. The 1-year and 5-year death-censored pancreas graft survival rates were 92.7% and 89.6%, respectively, with no significant difference between SPK and PAK (P = 0.330). Graft failure occurred in 10 patients, primarily due to pancreatitis and rejection. Donor-related factors, particularly anoxic brain injury, were significantly associated with lower graft survival (P = 0.045).</p><p><strong>Conclusion: </strong>PT outcomes in this cohort align with international standards, emphasizing the importance of donor selection and tailored immunosuppression. Expanding PT indications to include selective type 2 DM patients could benefit South Korea's PT programs with adequate resource allocation.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"108 5","pages":"271-278"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re-do laparoscopic common bile duct exploration for recurrent common bile duct stones: a single-center retrospective cohort study.","authors":"In Ho Lee, Seung Jae Lee, Ju Ik Moon, Sang Eok Lee, Nak Song Sung, Seong Uk Kwon, In Eui Bae, Seung Jae Rho, Sung Gon Kim, Min Kyu Kim, Dae Sung Yoon, Won Jun Choi, In Seok Choi","doi":"10.4174/astr.2025.108.5.310","DOIUrl":"https://doi.org/10.4174/astr.2025.108.5.310","url":null,"abstract":"<p><strong>Purpose: </strong>Common bile duct (CBD) stone recurrence after laparoscopic CBD exploration (LCBDE) is relatively common. No studies have been conducted evaluating the safety and feasibility of re-do LCBDE in the treatment of recurrent CBD stones.</p><p><strong>Methods: </strong>This single-center retrospective study reviewed 340 consecutive patients who underwent LCBDE for CBD stones between January 2004 and December 2020. Patients with pancreatobiliary malignancies and those who underwent other surgical procedures were excluded.</p><p><strong>Results: </strong>Of the 340 included patients, 45 experienced a recurrence after a mean follow-up period of 24.2 months. Of them, 18 underwent re-do LCBDE, 20 underwent endoscopic intervention, 2 underwent radiologic intervention, and 5 underwent observation. Re-do LCBDE and initial LCBDE showed similar surgical outcomes in terms of operative time (113.1 minutes <i>vs.</i> 107.5 minutes, P = 0.515), estimated blood loss (42.5 mL <i>vs.</i> 49.1 mL, P = 0.661), open conversion rate (2.9% <i>vs.</i> 0%, P = 0.461), postoperative complication (15.3% <i>vs.</i> 22.2%, P = 0.430), and postoperative hospital stay (6.5 days <i>vs.</i> 6.4 days, P = 0.921). Comparing re-do LCBDE and nonsurgical treatment (endoscopic or radiologic), no statistically significant differences were noted in posttreatment complication (22.2% <i>vs.</i> 13.6%, P = 0.477), hospital stay (6.4 days <i>vs.</i>7.3 days, P = 0.607), and recurrence (50.0% <i>vs.</i> 36.4%, P = 0.385). The clearance rate was higher in the re-do LCBDE group than in the nonsurgical group (100% <i>vs.</i> 81.8%, P = 0.057).</p><p><strong>Conclusion: </strong>Compared to initial LCBDE and endoscopic or radiological treatments, re-do LCBDE for recurrent CBD stones is a treatment option worth considering in selected patients.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"108 5","pages":"310-316"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumors arising from an axillary accessory breast: a 10-year retrospective cohort study at a single center.","authors":"Sung Ryul Lee, Ji Hyun Lee, Hyok Jo Kang","doi":"10.4174/astr.2025.108.5.302","DOIUrl":"https://doi.org/10.4174/astr.2025.108.5.302","url":null,"abstract":"<p><strong>Purpose: </strong>Pathologic lesions may occur in an axillary accessory breast (AAB). This study aimed to evaluate the characteristics of tumors arising from AABs and to recommend appropriate treatment.</p><p><strong>Methods: </strong>This retrospective study involved 3,544 women (18-65 years old) with AAB at Damsoyu Hospital in Korea from 2014 to 2023. The patients were divided into an AAB with benign tumors (TAAB) group and an AAB without tumors (AAB) group, and the tumors' pathologies were reviewed. A core biopsy was performed on tumors with possible malignancy identified by preoperative ultrasonography. All patients underwent complete excision of accessory mammary gland (AMG) tissue, including tumors. The postoperative results were checked 6 months after surgery.</p><p><strong>Results: </strong>Fifty-two out of 3,554 patients had tumors confirmed by preoperative ultrasonography. Preoperative core biopsies were performed on 11 patients. Two patients had malignant tumors (invasive ductal carcinoma) identified by core biopsy. Fifty patients had benign tumors identified by postoperative pathological analysis (46 fibroadenomas, 2 fibrocystic changes, and 2 sclerosing adenoses). Carcinoma <i>in situ</i> was confirmed in 2 patients using postoperative pathological analysis. No patients in either group developed tumors in the axilla during the follow-up period. All patients were satisfied with the axillary pain relief and the disappearance of bulging lesions.</p><p><strong>Conclusion: </strong>We recommend a core biopsy if preoperative ultrasonography indicates a possibly malignant tumor. AAB patients may experience tumors, pain, and bulging appearance of an AMG; thus, complete AMG excision is necessary.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"108 5","pages":"302-309"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breast cancer implant reconstructive surgery and radiotherapy: a retrospective analysis of medical records.","authors":"Ji Young Yun, Ki Jung Ahn, Hyunjung Kim, Hee Yeon Kim, Tae Hyun Kim, Kyung Do Byun, Ji Sun Park, Yunseon Choi","doi":"10.4174/astr.2025.108.5.295","DOIUrl":"https://doi.org/10.4174/astr.2025.108.5.295","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to analyze whether the occurrence of complications increases if radiotherapy (RT) is administered after breast reconstructive surgery using implants.</p><p><strong>Methods: </strong>This retrospective study included 80 patients who underwent breast reconstruction using implants, of which 16 (20.0%) underwent RT. Most patients underwent conventional fractionated RT (n = 13), and hypofractionated RT was performed in 3 patients. Most patients (n = 51, 63.8%) underwent delayed reconstruction, which involved implant replacement after tissue expander insertion. Only 29 patients (36.3%) underwent immediate reconstruction simultaneously with breast cancer surgery.</p><p><strong>Results: </strong>The median postoperative follow-up was 39.9 months (range, 8.7-120.3 months). Complications occurred in 18 (22.5%); infection/necrosis (n = 8), leakage/rupture (n = 8), and capsular contracture (n = 2). Infection/necrosis is common in patients undergoing RT. Complications occurred in 4 patients (25.0%) who received RT and 14 (21.9%) who did not receive RT, and complications did not significantly increase with RT (P = 0.511). There was no overall difference in complications between the immediate (4 of 29) and delayed (14 of 51) reconstruction groups (P = 0.129). Nine patients underwent reoperation because of complications; 3 (18.8%) received RT and 6 (9.4%) did not receive RT. The reoperation rate did not increase significantly with RT (P = 0.254). There were 3 cases of recurrence, and patients who received RT had no recurrence.</p><p><strong>Conclusion: </strong>RT did not significantly increase the complication or reoperation rates if reconstructive surgery was performed using implants. Therefore, RT should be performed in patients at a high risk of recurrence.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"108 5","pages":"295-301"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishment of an orthotopic nude mouse model for recurrent pancreatic cancer after complete resection: an experimental animal study.","authors":"Sung Eun Park, Tae Ho Hong","doi":"10.4174/astr.2025.108.5.317","DOIUrl":"https://doi.org/10.4174/astr.2025.108.5.317","url":null,"abstract":"<p><strong>Purpose: </strong>This study created a nude mouse model to study pancreatic cancer recurrence. Circumstances leading to the highest recurrence rates after curative surgery were also analyzed.</p><p><strong>Methods: </strong>A total of 135 nude mice were divided into 3 groups: sham, metastasis, and resection (45 mice in each group). In sham and resection groups, AsPc-1 cells suspended in a synthetic extracellular matrix were injected into the tail of the pancreas of each mouse. In the metastasis group, cells were injected into the spleen. After 3 weeks, the resection group underwent distal pancreatectomy and the metastasis group underwent diagnostic laparotomy to confirm metastasis. To assess disease recurrence, the resection group was monitored weekly using luminescence imaging. Diagnostic exploration was conducted 3 weeks after surgery. Recurrence rate was evaluated and histological examination was performed for the resection group.</p><p><strong>Results: </strong>Among 45 mice, 43 developed cancerous masses in the tail of the pancreas without invading adjacent organs 3 weeks after the initial orthotopic injection. Of those 43 mice, one died due to intraoperative bleeding during complete surgical resection. Pancreatic cancer recurrence was observed in 37 of 42 mice (88.1%) at an average of 21.8 ± 2.2 days. Histological examination showed high nuclear pleomorphism and neoangiogenesis.</p><p><strong>Conclusion: </strong>We developed an efficient model that could demonstrate recurrence after complete resection of pancreatic cancer. By confirming that recurrence occurs after surgery using this protocol, our model is expected to contribute to the development of various treatment strategies.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"108 5","pages":"317-324"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The efficacy of skin soft tissue expansion and recombinant human epidermal growth factor in the repair of second-degree scald scars: a prospective single-blind randomized controlled trial.","authors":"Hui He, Miaomiao Xu, Wenlu Zhang, Jia Ye","doi":"10.4174/astr.2025.108.5.325","DOIUrl":"https://doi.org/10.4174/astr.2025.108.5.325","url":null,"abstract":"<p><strong>Purpose: </strong>This research observed the efficacy and safety of soft tissue expansion combined with recombinant human epidermal growth factor (rhEGF) in repairing second-degree scald scars.</p><p><strong>Methods: </strong>This study conducted a prospective, single-blind, randomized controlled trial. Eighty-four patients with deep second-degree scald scars were evenly divided into the control and observation groups. The control group was treated with soft tissue expansion, and the observation group was additionally treated with rhEGF. The skin expansion and wound healing times were compared. The changes in wound exudate and inflammation around the wound were observed after first-stage surgery. The hydroxyproline (OHP) and collagen I/III ratios were compared during the second stage of surgery. The complications and repair effects during treatment were evaluated.</p><p><strong>Results: </strong>The observation group exhibited lower expansion time, immediate retraction rate, and wound healing time, higher skin expansion rate, higher wound exudate score and inflammation score, higher OHP, lower collagen I/III, lower complication rate, and higher total effective rate than the control group (all P < 0.05).</p><p><strong>Conclusion: </strong>Skin soft tissue expansion combined with rhEGF is more effective in repairing second-degree scald scars, which can effectively increase skin expansion area and reduce wound infection and complications.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"108 5","pages":"325-330"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of initial treatments for resectable hepatocellular carcinoma within Milan criteria: an observational study based on a nationwide survey.","authors":"Sang Jin Kim, Woo Kyoung Jeong, Hyung-Joon Han, Gyu-Seong Choi, Kyun-Hwan Kim, Jongman Kim","doi":"10.4174/astr.2025.108.5.279","DOIUrl":"https://doi.org/10.4174/astr.2025.108.5.279","url":null,"abstract":"<p><strong>Purpose: </strong>Treatment options for hepatocellular carcinoma (HCC) vary according to known guidelines among liver resection (LR), liver transplantation (LT), radiofrequency ablation (RFA), and transarterial chemoembolization (TACE). This study aimed to compare the outcomes of initial treatment for patients with resectable HCC within Milan criteria (MC) via nationwide data.</p><p><strong>Methods: </strong>Patients with resectable HCC (Child-Pugh class A; platelet count, ≥100,000/µL) within MC from the Korean Liver Cancer Association databank were analyzed, retrospectively. Outcomes according to initial treatment and subgroups according to tumor size and number were analyzed. Overall survival (OS) rates after initial treatment were compared.</p><p><strong>Results: </strong>A total of 3,241 patients who underwent LR (n = 1,371), LT (n = 12), RFA (n = 679), or TACE (n = 1,179) were included. The 5-year OS rates differed significantly between the groups (P < 0.05), except for LT (LR, 84.9%; LT, 82.5%; RFA, 76.2%; and TACE, 59.9%). For patients with a single tumor of any size, the 5-year OS rates of the LR group were significantly higher than RFA and TACE groups. For patients with multiple tumors, the 5-year OS rates were 78.2%, 100%, 74.3%, and 53.0% for the LR, LT, RFA, and TACE groups, respectively, but without significant difference between LR and RFA (P = 0.86).</p><p><strong>Conclusion: </strong>For resectable HCC within MC, the LR had the highest OS rate for a single tumor of any size. LR and RFA showed no significant differences in OS rate for multiple tumors. LR has a much more optimistic outlook for HCC within MC.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"108 5","pages":"279-294"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CORRIGENDUM: Correction of the grant number. Proposal of age definition for early-onset gastric cancer based on the Korean Gastric Cancer Association nationwide survey data: a retrospective observational study.","authors":"Seong-A Jeong, Ji Sung Lee, Ba Ool Seong, Seul-Gi Oh, Chang Seok Ko, Sa-Hong Min, Chung Sik Gong, Beom Su Kim, Moon-Won Yoo, Jeong Hwan Yook, In-Seob Lee","doi":"10.4174/astr.2025.108.5.331","DOIUrl":"https://doi.org/10.4174/astr.2025.108.5.331","url":null,"abstract":"<p><p>[This corrects the article on p. 245 in vol. 108, PMID: 40226172.].</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"108 5","pages":"331-355"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of portal/superior mesenteric vein abutment angle on prognosis in pancreatic cancer: a single-center retrospective cohort study.","authors":"Hye Jeong Jeong, DanHui Heo, Soo Yeun Lim, Hyeong Seok Kim, Hochang Chae, So Jeong Yoon, Sang Hyun Shin, In Woong Han, Jin Seok Heo, Ji Hye Min, Hongbeom Kim","doi":"10.4174/astr.2025.108.4.231","DOIUrl":"https://doi.org/10.4174/astr.2025.108.4.231","url":null,"abstract":"<p><strong>Purpose: </strong>Pancreatic cancer has a poor prognosis; however, the implementation of neoadjuvant treatment enables borderline resectable cases to undergo curative resection and improves the overall survival rate. Attempts have been made to expand the eligibility criteria for neoadjuvant treatment, even in resectable cases. Some studies have suggested a correlation between vein abutment and poor prognosis or that the abutment angle may affect prognosis. This study investigated the anatomical factors affecting the vessel abutment angle and its prognostic value in pancreatic cancer.</p><p><strong>Methods: </strong>Patients with pancreatic ductal adenocarcinoma who underwent surgery between 2012 and 2017 were included in this study. Patients who underwent neoadjuvant treatment were excluded. Data from only the intent-to-treat pancreaticoduodenectomy group were included in the analysis. Clinicopathological characteristics; preoperative factors such as CA 19-9, preoperative biliary drainage, American Society of Anesthesiologists physical status classification, portal vein/superior mesenteric vein contact angle measured via CT scan; and intraoperative factors were collected for analysis.</p><p><strong>Results: </strong>A total of 365 patients were included in this study, and the abutment group included 92 patients (25.2%). The abutment and no-contact groups did not show any significant differences in terms of the overall survival or disease-free survival rate. Among the abutment groups, patients with less than 90° and 90°-180° did not show any significant differences. In the multivariate analysis, the only preoperative factor that had a prognostic effect was CA 19-9, a biological factor.</p><p><strong>Conclusion: </strong>When there is no vessel invasion in the abutment group, upfront surgery should be considered because the angle does not affect the overall prognosis.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"108 4","pages":"231-239"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11982446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}