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Surgical Outcome Af...
Surgical Outcome After Distal Pancreatectomy With and Without Portomesenteric Venous Resection in Patients with Pancreatic Adenocarcinoma: A Transatlantic Evaluation of Patients in North America, Germany, Sweden, and The Netherlands (GAPASURG)
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- Stoop, Thomas F. (författare)
- Univ Colorado Anschutz Med Campus, CO 80045 USA; Locat Univ Amsterdam, Netherlands; Canc Ctr Amsterdam, Netherlands; Karolinska Inst, Sweden
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- Augustinus, Simone (författare)
- Locat Univ Amsterdam, Netherlands; Canc Ctr Amsterdam, Netherlands
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- Björnsson, Bergthor (författare)
- Linköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Kirurgiska kliniken US
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- Tingstedt, Bobby (författare)
- Lund Univ, Sweden
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- Andersson, Bodil (författare)
- Lund Univ, Sweden
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- Wolfgang, Christopher L. (författare)
- NYU, NY USA
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- Werner, Jens (författare)
- Univ Hosp LMU Munich, Germany,Radboud Univ Nijmegen, Netherlands
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- Johansen, Karin (författare)
- Linköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten
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- Stommel, Martijn W. J. (författare)
- Radboud Univ Nijmegen, Netherlands
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- Katz, Matthew H. G. (författare)
- Univ Texas MD Anderson Canc Ctr, TX USA
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- Ghadimi, Michael (författare)
- Univ Med Ctr Gottingen, Germany,Indiana Univ Sch Med, IN USA
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- House, Michael G. (författare)
- Indiana Univ Sch Med, IN USA
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- Ghorbani, Poya (författare)
- Karolinska Inst, Sweden
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- Molenaar, I. Quintus (författare)
- Univ Med Ctr Utrecht, Netherlands; Univ Med Ctr Utrecht, Netherlands
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- de Wilde, Roeland F. (författare)
- Univ Med Ctr, Netherlands
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- Mieog, J. Sven D. (författare)
- Leiden Univ, Netherlands
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- Keck, Tobias (författare)
- UKSH Campus Lubeck, Germany
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- Wellner, Ulrich F. (författare)
- UKSH Campus Lubeck, Germany
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- Uhl, Waldemar (författare)
- Ruhr Univ Bochum, Germany
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- Besselink, Marc G. (författare)
- Locat Univ Amsterdam, Netherlands; Canc Ctr Amsterdam, Netherlands
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- Pitt, Henry A. (författare)
- Rutgers Canc Inst New Jersey, NJ 08901 USA
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- Del Chiaro, Marco (författare)
- Univ Colorado Anschutz Med Campus, CO 80045 USA
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(creator_code:org_t)
- 2024
- 2024
- Engelska.
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Ingår i: Annals of Surgical Oncology. - : SPRINGER. - 1068-9265 .- 1534-4681.
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- BackgroundPancreatic adenocarcinoma located in the pancreatic body might require a portomesenteric venous resection (PVR), but data regarding surgical risks after distal pancreatectomy (DP) with PVR are sparse. Insight into additional surgical risks of DP-PVR could support preoperative counseling and intraoperative decision making. This study aimed to provide insight into the surgical outcome of DP-PVR, including its potential risk elevation over standard DP.MethodsWe conducted a retrospective, multicenter study including all patients with pancreatic adenocarcinoma who underwent DP +/- PVR (2018-2020), registered in four audits for pancreatic surgery from North America, Germany, Sweden, and The Netherlands. Patients who underwent concomitant arterial and/or multivisceral resection(s) were excluded. Predictors for in-hospital/30-day major morbidity and mortality were investigated by logistic regression, correcting for each audit.ResultsOverall, 2924 patients after DP were included, of whom 241 patients (8.2%) underwent DP-PVR. Rates of major morbidity (24% vs. 18%; p = 0.024) and post-pancreatectomy hemorrhage grade B/C (10% vs. 3%; p = 0.041) were higher after DP-PVR compared with standard DP. Mortality after DP-PVR and standard DP did not differ significantly (2% vs. 1%; p = 0.542). Predictors for major morbidity were PVR (odds ratio [OR] 1.500, 95% confidence interval [CI] 1.086-2.071) and conversion from minimally invasive to open surgery (OR 1.420, 95% CI 1.032-1.970). Predictors for mortality were higher age (OR 1.087, 95% CI 1.045-1.132), chronic obstructive pulmonary disease (OR 4.167, 95% CI 1.852-9.374), and conversion from minimally invasive to open surgery (OR 2.919, 95% CI 1.197-7.118), whereas concomitant PVR was not associated with mortality.ConclusionsPVR during DP for pancreatic adenocarcinoma in the pancreatic body is associated with increased morbidity, but can be performed safely in terms of mortality.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Nyckelord
- Distal pancreatectomy; Venous resection; Surgical outcome; Pancreatic cancer
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Stoop, Thomas F.
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Augustinus, Simo ...
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Björnsson, Bergt ...
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Tingstedt, Bobby
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Andersson, Bodil
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Wolfgang, Christ ...
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Werner, Jens
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Johansen, Karin
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Stommel, Martijn ...
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Katz, Matthew H. ...
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Ghadimi, Michael
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House, Michael G ...
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Ghorbani, Poya
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Molenaar, I. Qui ...
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de Wilde, Roelan ...
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Mieog, J. Sven D ...
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Keck, Tobias
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Wellner, Ulrich ...
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Uhl, Waldemar
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Besselink, Marc ...
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Pitt, Henry A.
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Del Chiaro, Marc ...
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