Appraisal of Laparoscopic Distal Pancreatectomy for Left-Sided Pancreatic Cancer: A Large Volume Cohort Study of 152 Consecutive PatientsReportar como inadecuado




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Background

The aim of this study was to appraise the value of laparoscopic distal pancreatectomy LDP for left-sided pancreatic cancer based on a large volume cohort study.

Methods

We reviewed data for all consecutive patients undergoing LDP for left-sided pancreatic cancer at Asan Medical Center Seoul, Korea between December 2006 and December 2014.

Results

A total of 91 male and 61 female patients, with a median age of 62.7 years were included in this study. The median operative duration was 234 minutes. Pathological reports revealed the following: a median tumor size of 3.0 cm range, 0.4–10.0, T stages T1 in 7.9%, T2 in 5.3%, T3 in 86.8%, and no T4, the tumor differentiation well differentiated in 16.4%, moderately differentiated in 75.4%, and poorly differentiated in 8.2%, and R0 resection in 126 patients 82.9%. After pancreatectomy, 96 patients 63.2% received adjuvant chemotherapy, and the median time to chemotherapy was 30 days. The median length of hospital stay was 8 days range, 5–31, and the median time to diet resumption was 1 day. Grade B or C postoperative pancreatic fistula occurred in 14 patients 9.2% and grade II or III complications occurred in 27 17.7%. The median overall survival was 43.0 months. A Cox proportional hazards model showed that tumor size, N1 stage, combined resection, and incompleteness of planned adjuvant chemotherapy affect patient survival.

Conclusions

LDP for left-sided pancreatic cancer is reasonable within selected indications. An international consensus on laparoscopic surgery for pancreatic cancer would be desirable and timely.



Autor: Sang Hyun Shin, Song Cheol Kim , Ki Byung Song, Dae Wook Hwang, Jae Hoon Lee, Kwang-Min Park, Young-Joo Lee

Fuente: http://plos.srce.hr/



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