Can post-hoc video review of robotic pancreaticoduodenectomy predict portal/superior mesenteric vein margin status in pancreatic adenocarcinoma?
| Autor: | Mazen S. Zenati, Richard L. Simmons, Jae P. Jung, Amer H. Zureikat, Herbert J. Zeh, Melissa E. Hogg, Ahmad Hamad, Brian A. Boone |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Article Pancreaticoduodenectomy 03 medical and health sciences 0302 clinical medicine Mesenteric Veins Robotic Surgical Procedures Margin (machine learning) medicine Carcinoma Humans Neoplasm Invasiveness Superior mesenteric vein Vein Aged Retrospective Studies Hepatology business.industry Portal Vein Gastroenterology Margins of Excision Retrospective cohort study Middle Aged medicine.disease Margin status Vascular Neoplasms Pancreatic Neoplasms medicine.anatomical_structure 030220 oncology & carcinogenesis Adenocarcinoma 030211 gastroenterology & hepatology Female Radiology business Carcinoma Pancreatic Ductal Follow-Up Studies |
| Zdroj: | HPB (Oxford) |
| Popis: | Background Achieving margin negative resection is a significant determinant of outcome in pancreatic adenocarcinoma (PDA). However, because of the fibrotic nature of PDA, it can be difficult to discriminate fibrosis from active disease intra-operatively. We sought to determine if post-hoc video review of robotic pancreatico-duodenectomy (RPD) could predict the portal/superior mesenteric vein (PV/SMV) margin status on final pathology. Methods Experienced pancreatic surgeons, blinded to patient and operative variables, reviewed the PV/SMV margin for available RPD videos of consecutive PDA patients from 9/2012 through 6/2017. Results 107 RPD videos were reviewed. Of 76 patients (71%) predicted to have a negative vein margin on video review, 20 patients (26%) had a pathologic positive margin. 25 of 31 patients (81%) predicted to have positive margin on video review were positive on pathology. The specificity of video prediction was 90.3% with a sensitivity of 55.6% and an accuracy of 75.7%. Conclusion Post-hoc video review prediction is unable to reliably predict a positive (R1) margin at the portal vein/SMV, suggesting that intra-operative clinical assessment may be suboptimal in determining the need for more extensive resections. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|