A novel surgical option for artery-involving pancreatic cancer: sub-adventitial divestment technique
10.3760/cma.j.cn115610-20220221-00097
- VernacularTitle:侵犯动脉的胰腺癌外科治疗新选择：动脉鞘剥除技术
- Author:
Yi MIAO
1
;
Baobao CAI
;
Zipeng LU
Author Information
1. 南京医科大学第一附属医院胰腺中心，南京 210029
- Keywords:
Pancreatic neoplasms;
Locally advanced;
Resectability evaluation;
Sub-adventitial divestment;
Combined artery resection
- From:
Chinese Journal of Digestive Surgery
2022;21(4):456-460
- CountryChina
- Language:Chinese
-
Abstract:
Radical resection remains as the key treatment to improve the prognosis of pancreatic cancer, and arterial invasion hinders radical resection for locally advanced lesions. More accurate assessment of resectability and selection of appropriate surgical techniques depend on better understanding of the anatomy, histology, and tumor biology of pancreatic cancer invasion to the artery. Traditional radiology assessment for artery involvement, based on the circumference of involved arteries, is not equivalent to pathological artery invasion. The depth of arterial invasion is more important than the circumference in evaluating resectability. Results of morphological observa-tion on arterial structure shows that both the feasibility of sub-adventitial divestment technique (SDT) and the necessity of arterial resection depend on whether the external elastic lamina of artery is invaded. The SDT can provide an opportunity for radical resection for pancreatic cancer with arterial invasion, while avoiding the high mortality and incidence of complications caused by arterial resection. A more precise assessment of tumor invasion depth and biological behavior will provide a more reliable basis for surgical decision for the treatment of locally advanced pancreatic cancer with arterial invasion.
