Laparoscopic radical antegrade modular pancreatosplenectomy for left-sided pancreatic cancer using the ligament of Treitz approach

@article{Ome2017LaparoscopicRA,
  title={Laparoscopic radical antegrade modular pancreatosplenectomy for left-sided pancreatic cancer using the ligament of Treitz approach},
  author={Y. Ome and K. Hashida and M. Yokota and Y. Nagahisa and Okabe Michio and K. Kawamoto},
  journal={Surgical Endoscopy},
  year={2017},
  volume={31},
  pages={4836-4837}
}
BackgroundLaparoscopic distal pancreatectomy (Lap-DP) for benign lesions or those with low malignant potential has been proven safe and effective, and its performance is now widespread [1–3]. Lap-DP for left-sided pancreatic cancer (PC) is also being increasingly performed. According to some reports, Lap-DP has superior short-term outcomes (blood loss, postoperative hospital stay) and comparable oncological outcomes and overall survival with those of open distal pancreatectomy (Op-DP) [4–6]. PC… Expand

Paper Mentions

Interventional Clinical Trial
Pancreatic cancer is regarded as "the king of cancer". It is extremely malignant, with a low sensibility to chemotherapy and radiotherapy, and a poor prognosis. Surgical treatment is… Expand
ConditionsPancreatic Cancer, Surgery
InterventionProcedure
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Background Due to its technical complexity, laparoscopic (L-) radical antegrade modular pancreatosplenectomy (RAMPS) for left-sided pancreatic ductal adenocarcinoma (PDAC) has been described in a fewExpand
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TLDR
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TLDR
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TLDR
L-aRAMPS is technically safe and oncologically feasible to secure favorable surgical outcomes for resectable PC patients to assess the safety and feasibility of laparoscopic radical antegrade modular pancreatosplenectomy with an artery-first approach as compared with open aRAMPS in resectables PC using matched-pair analysis. Expand
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TLDR
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TLDR
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TLDR
LDP with a clockwise approach for dissection, combined with the progressive stepwise compression technique for pancreatic transection resulted in excellent outcomes including a very low POPF rate. Expand
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Laparoscopic RAMPS could be a safe and oncologically feasible procedure in well-selected patients with left-sided pancreatic cancer and achieve feasible perioperative results accompanied by acceptable survival outcomes. Expand
Laparoscopic modified anterior RAMPS in well-selected left-sided pancreatic cancer: technical feasibility and interim results
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Laparoscopic modified anterior RAMPS is thought to be technically feasible for curative resection in well-selected pancreatic cancer and the oncologic feasibility needs to be investigated based on long-term follow-up. Expand
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The ligament of Treitz approach in laparoscopic modified RAMPS offered tumor‐free margins and the resection of sufficient regional LN and allowed adjuvant chemotherapy to be started early. Expand
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RAMPS procedure can achieve negative tangential margins in a high percent of patients with resectable carcinoma of the body and tail of the pancreas and are quite satisfactory for this tumor and are similar to rates reported for the Whipple procedure. Expand
The laparoscopic approach to distal pancreatectomy for ductal adenocarcinoma results in shorter lengths of stay without compromising oncologic outcomes.
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LDP for DAC provides shorter postoperative lengths of stay and rates of readmission and 30-day mortality similar to OPD without compromising perioperative oncologic outcomes. Expand
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TLDR
A new antegrade procedure has been developed that provides improved visibility, removes N1 nodes, and permits adjustment of the depth of the posterior extent of resection coupled with early rather than late control of the vasculature. Expand
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TLDR
RAMPS is associated with high negative tangential margin rates and very satisfactory survival rates for this aggressive tumor. Expand
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The laparoscopic approach in the treatment of PDAC seems to be safe and efficacious, however, additional prospective, randomised, multicentric trials are needed to correctly evaluate the laparoscope approach in PDAC. Expand
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Laparoscopic Distal Pancreatectomy Is Associated With Significantly Less Overall Morbidity Compared to the Open Technique: A Systematic Review and Meta-Analysis
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The improved complication profile of LDP, taken together with the lack of compromise of margin status, suggests that this technique is a reasonable approach in selected cancer patients. Expand
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