Oncological Outcome After Laparoscopic 'No-touch' RAMPS Versus 'Touch' Left Pancreatectomy for Pancreatic Adenocarcinoma.

Autor:	Mazzotta AD; Department of Digestive, Oncological and Metabolic Surgery, Institut Mutualiste Montsouris, Paris, France; alex.mazzotta@gmail.com., VAN Bodegraven EA; Amsterdam UMC, Department of Surgery, University of Amsterdam, Amsterdam, the Netherlands.; Cancer Center Amsterdam, Amsterdam, the Netherlands., Petrucciani N; Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, St Andrea Hospital, Sapienza University, Rome, Italy., Usai S; Department of Digestive, Oncological and Metabolic Surgery, Institut Mutualiste Montsouris, Paris, France., Carneiro AC; Department of Digestive, Oncological and Metabolic Surgery, Institut Mutualiste Montsouris, Paris, France., Tribillon E; Department of Digestive, Oncological and Metabolic Surgery, Institut Mutualiste Montsouris, Paris, France., Ferraz JM; Department of Digestive, Oncological and Metabolic Surgery, Institut Mutualiste Montsouris, Paris, France., Busch OR; Amsterdam UMC, Department of Surgery, University of Amsterdam, Amsterdam, the Netherlands.; Cancer Center Amsterdam, Amsterdam, the Netherlands., Gayet B; Department of Digestive, Oncological and Metabolic Surgery, Institut Mutualiste Montsouris, Paris, France., Besselink MG; Amsterdam UMC, Department of Surgery, University of Amsterdam, Amsterdam, the Netherlands.; Cancer Center Amsterdam, Amsterdam, the Netherlands., Soubrane O; Department of Digestive, Oncological and Metabolic Surgery, Institut Mutualiste Montsouris, Paris, France.
Jazyk:	angličtina
Zdroj:	Anticancer research [Anticancer Res] 2023 Nov; Vol. 43 (11), pp. 4983-4991.
DOI:	10.21873/anticanres.16697
Abstrakt:	Background/aim: The validity of laparoscopic distal pancreatectomy in left-sided pancreatic adenocarcinoma (PDAC) is still unclear. However, a meticulous surgical dissection through a "no-touch" technique might allow a radical oncological resection with minimal risk of tumor dissemination and seeding. This study aimed to evaluate the oncological outcomes of the laparoscopic "no touch" technique versus the "touch" technique. Patients and Methods: From 2001 to 2020, we retrospectively analyzed 45 patients undergoing laparoscopic distal pancreatectomy (LDP) for PDAC in two centers. Factors associated with overall (OS), disease-free survival (DFS) and time to recurrence (TTR) were identified. Results: The OS rates in the 'no-touch' and 'touch' groups were 95% vs. 78% (1-year OS); 50% vs. 50% (3-year OS), respectively (p=0.60). The DFS rates in the 'no-touch' and 'touch' groups were 72 % vs. 57% (1-year DFS); 32% vs. 28% (3-year DFS), respectively (p=0.11). The TTR rates in the 'no-touch' and 'touch' groups were 77% vs. 61% (1-year TTR); 54% vs. 30% (3-year TTR); 46% vs. 11% (5-year TTR); respectively (p=0.02) In multivariate analysis the only factors were Touch technique [odds ratio (OR)=2.62, p=0.02] and lymphovascular emboli (OR=4.8; p=0.002). Conclusion: We advise the 'no-touch' technique in patients with resectable PDAC in the pancreatic body and tail. Although this study does not provide definitive proof of superiority, no apparent downsides are present for the 'no-touch' technique in this setting although there could be oncological benefits. (Copyright © 2023, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)
Databáze:	MEDLINE
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