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- Title
Anterior versus posterior radical antegrade modular pancreatosplenectomy for pancreatic body and tail cancer: an inverse probability of treatment weighting with survival analysis.
- Authors
Kuriyama, Naohisa; Maeda, Koki; Shinkai, Toru; Ito, Takahiro; Gyoten, Kazuyuki; Hayasaki, Aoi; Fujii, Takehiro; Iizawa, Yusuke; Murata, Yasuhiro; Tanemura, Akihiro; Kishiwada, Masashi; Nagata, Motonori; Ichikawa, Shuhei; Mizuno, Shugo
- Abstract
Purpose: Radical antegrade modular pancreatosplenectomy (RAMPS) is a standard procedure for patients with pancreatic body and tail cancer. There are two types of RAMPS: anterior and posterior, but their indications and surgical outcomes remain unclear. We compared the surgical outcomes, postoperative course, and prognosis between anterior and posterior RAMPS. Methods: Between 2007 and 2020, 105 consecutive patients who underwent RAMPS for pancreatic body and tail cancers were divided into an anterior RAMPS group (n = 30) and a posterior RAMPS group (n = 75). To adjust for differences in preoperative characteristics and intraoperative procedures, an inverse probability of treatment weighting (IPTW) analysis was done, using propensity scores. Results: After IPTW adjustment, the postoperative body temperature of the posterior RAMPS group and the amount of drain discharge in the anterior RAMPS group were significantly lower, from postoperative days (PODs) 1 to 3, but there were no differences in postoperative complications, recurrence patterns, or prognosis between the two groups. Regarding the diagnostic ability of multidetector-row computed tomography (MD-CT) for direct tumor involvement of the left adrenal gland, the sensitivity and specificity were 100% and 90.0%, respectively. Conclusion: Pancreatic body and tail cancer without apparent preoperative direct tumor involvement of the left adrenal gland on MD-CT may be sufficient indication for anterior RAMPS.
- Subjects
PANCREATIC cancer; SURVIVAL analysis (Biometry); ADRENAL glands
- Publication
Surgery Today, 2023, Vol 53, Issue 8, p917
- ISSN
0941-1291
- Publication type
Article
- DOI
10.1007/s00595-023-02651-7