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首页> 外文期刊>World journal of gastroenterology : >Minimally invasive radical pancreatectomy for left-sided pancreatic cancer: Current status and future perspectives
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Minimally invasive radical pancreatectomy for left-sided pancreatic cancer: Current status and future perspectives

机译：微创根治性胰腺切除术治疗左侧胰腺癌的现状和未来展望

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摘要

Minimally invasive distal pancreatectomy with splenectomy has been regarded as a safe and effective treatment for benign and borderline malignant pancreatic lesions. However, its application for left-sided pancreatic cancer is still being debated. The clinical evidence for radical antegrade modular pancreatosplenectomy (RAMPS)-based minimally invasive approaches for left-sided pancreatic cancer was reviewed. Potential indications and surgical concepts for minimally invasive RAMPS were suggested. Despite the limited clinical evidence for minimally invasive distal pancreatectomy in left-sided pancreatic cancer, the currently available clinical evidence supports the use of laparoscopic distal pancreatectomy under oncologic principles in wellselected left sided pancreatic cancers. A pancreasconfined tumor with an intact fascia layer between the pancreas and left adrenal gland/kidney positioned more than 1 or 2 cm away from the celiac axis is thought to constitute a good condition for the use of margin-negative minimally invasive RAMPS. The use of minimally invasive (laparoscopic or robotic) anterior RAMPS is feasible and safe for margin-negative resection in well-selected left-sided pancreatic cancer. The oncologic feasibility of the procedure remains to be determined; however, the currently available interim results indicate that even oncologic outcomes will not be inferior to those of open radical distal pancreatosplenectomy. (C) 2014 Baishideng Publishing Group Co., Limited. All rights reserved.
机译：微创远端胰腺切除联合脾切除术被认为是对良性和交界性胰腺恶性病变的一种安全有效的治疗方法。然而，其在左侧胰腺癌中的应用仍在争论中。回顾了基于根治性顺行模块化胰腺脾切除术（RAMPS）的微创方法治疗左侧胰腺癌的临床证据。建议了微创RAMPS的潜在适应症和手术概念。尽管在左侧胰腺癌中微创远端胰腺切除术的临床证据有限，但目前可用的临床证据支持根据肿瘤学原则在选定的左侧胰腺癌中使用腹腔镜远端胰腺切除术。在距腹腔轴1或2 cm以上的胰腺和左肾上腺/肾之间有完整的筋膜层的胰腺局限性肿瘤被认为是使用阴性阴性微创RAMPS的良好条件。对于精心挑选的左侧胰腺癌，微创（腹腔镜或机器人）前RAMPS切缘阴性切除术是可行且安全的。该方法的肿瘤学可行性尚待确定;然而，目前可获得的中期结果表明，即使肿瘤学结果也不会逊于开放性根治性远端胰脾切除术。 （C）2014百事登出版集团有限公司。版权所有。

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