Venous resections and reconstructions in surgery of pancreatic cancer

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Abstract


Aim. To evaluate results of venous resections in tumor infiltration of venous wall in pancreatic cancer (PC).

Materials and Methods. The study included 74 patients with PC and tumor invasion of the wall of the mesenteric-portal system (T3 N0-1 M0). The control group included patients (n=53), receiving palliative chemotherapy. The average age of patients in the group of surgical treatment was 61.8±9.8 years, in the control group – 63.2±10.1 years (р>0.05), the average diameter of the tumor was 39 mm and 43 mm, respectively (р>0.05). In 62 cases of the group of surgical treatment the tumor was located in the head of pancreas (P), the patients were conducted pancreaticoduodenal resection with venous resection. In the rest of cases (n=12) the tumor was located in the body of P, corporocaudal resection of P was conducted with venous resection.

Results. In the early postoperative period 2.7% of patients developed thrombosis of the reconstruction zone, 1.4% developed bleeding. 30-Day postoperative lethality was 4.1%. Median survival in surgical treatment of PC with venous resection was higher in comparison with palliative chemotherapy: 19 months vs 13 months, р<0.05. In the group of venous resection the lowest annual survival (46.2%) was noted in patients with marginal resection of the vein. No significant differences were found in the parameters of survival with use of direct venous anastomose and venous prosthetics (66.7% vs 63.2%, p>0.05).

Conclusions. Angioplastic interventions permitting to achieve microscopically complete resection of the tumor in PC with tumor infiltration of mesenteric-portal system, permit to improve survival of patients in comparison with palliative chemotherapy.


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About the authors

Oleg I. Kit

Rostov Research Institute of Oncology

Email: vlu@aaanet.ru
ORCID iD: 0000-0003-3061-6108

Russian Federation, Rostov-on-Don

Corr. Memb. RAS, D. Sci. (Med.), Prof.

Oksana V. Katelnitskaya

Rostov Research Institute of Oncology

Author for correspondence.
Email: katelnizkji@mail.ru
ORCID iD: 0000-0002-7777-9943
SPIN-code: 6459-0334
ResearcherId: G-9110-2019

Russian Federation, Rostov-on-Don

MD, PhD, Cardiovascular Surgeon of the Department №2 of Abdominal Surgery

Andrey A. Maslov

Rostov Research Institute of Oncology

Email: Maslovaa@rnioi.ru
ORCID iD: 0000-0003-4902-5789
SPIN-code: 5963-5915
ResearcherId: W-5180-2019

Russian Federation, Rostov-on-Don

MD, PhD, Professor, Honored Doctor of the Russian Federation, Chief Physician, Head of the Department of Abdominal Oncology №3

Yuriy A. Gevorkyan

Rostov Research Institute of Oncology

Email: rnioi@list.ru
ORCID iD: 0000-0003-1957-7363
SPIN-code: 8643-2348

Russian Federation, Rostov-on-Don

MD, PhD, Professor, Head of the Abdominal Oncology Department №2

Evgeniy N. Kolesnikov

Rostov Research Institute of Oncology

Email: bony91@yandex.ru
ORCID iD: 0000-0001-9749-709X
SPIN-code: 8434-6494

Russian Federation, Rostov-on-Don

MD, PhD, Head of the Abdominal Oncology Department №1

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Copyright (c) 2020 Kit O.I., Katelnitskaya O.V., Maslov A.A., Gevorkyan Y.A., Kolesnikov E.N.

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