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Minimally invasive radical pancreatectomy for left-sided pancreatic cancer: Current status and future perspectives.

Authors
 Chang Moo Kang  ;  Sung Hwan Lee  ;  Woo Jung Lee 
Citation
 WORLD JOURNAL OF GASTROENTEROLOGY, Vol.20(9) : 2343-2351, 2014 
Journal Title
 WORLD JOURNAL OF GASTROENTEROLOGY 
ISSN
 1007-9327 
Issue Date
2014
MeSH
Humans ; Laparoscopy*/adverse effects ; Laparoscopy*/trends ; Neoplasm, Residual ; Pancreatectomy/adverse effects ; Pancreatectomy/methods* ; Pancreatectomy/trends ; Pancreatic Neoplasms/pathology ; Pancreatic Neoplasms/surgery* ; Robotics*/trends ; Splenectomy ; Surgery, Computer-Assisted*/adverse effects ; Surgery, Computer-Assisted*/trends ; Tomography, X-Ray Computed ; Treatment Outcome
Keywords
Laparoscopic pancreatectomy. Robotic pancreatectomy ; Pancreatic cancer
Abstract
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 well-selected left sided pancreatic cancers. A pancreas-confined 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.
Files in This Item:
T201400668.pdf Download
DOI
10.3748/wjg.v20.i9.2343
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Chang Moo(강창무) ORCID logo https://orcid.org/0000-0002-5382-4658
Lee, Sung Hwan(이성환)
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/98316
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