Radical antegrade modular pancreatosplenectomy for all pancreatic body and tail tumors: rationale and results

Langenbeck's Archives of Surgery
Masillamany SivasankerShailesh V Shrikhande

Abstract

Radical antegrade modular pancreatosplenectomy (RAMPS) has been propagated as the standard of care for pancreatic cancers involving the body and tail of the pancreas. This procedure has been shown to have promising results in enhancing the microscopically negative tangential resection margins as well as the lymph node yield. This is a retrospective analysis of prospectively maintained database on the resections performed for all pancreatic body and tail tumors at Tata Memorial Centre. Sixty-five patients underwent RAMPS without any perioperative mortality. The various pathologies comprised of adenocarcinoma (41.5%), neuroendocrine tumors (12.3%), solid pseudopapillary epithelial neoplasm (15.3%), cystic neoplasms (15.2%), etc. The R0 resection rate was 87.7%. Among this cohort, 27 patients had pancreatic adenocarcinoma. The 3-year OS and DFS for distal pancreatic cancers were 56% and 38%, respectively, but 3-year OS and DFS for other distal pancreatic tumors were 97% and 73%, respectively. On multivariate analysis, R0 resection significantly improved disease-free survival (p = 0.023) for pancreatic cancer. RAMPS procedure aids to achieve high negative tangential margins for all tumors involving the body and tail of the pancreas...Continue Reading

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Citations

Aug 2, 2020·Langenbeck's Archives of Surgery·S FerenczD Kelemen
Feb 17, 2021·World Journal of Surgical Oncology·Li JiangXiao-Ping Chen
May 29, 2021·The British Journal of Surgery·M SchneiderM W Büchler
Aug 31, 2020·Journal of Nippon Medical School = Nippon Ika Daigaku Zasshi·Satoshi MizutaniHiroshi Yoshida

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