Clinical Analysis Of Radical Antegrade Modular Pancreatosplenectomy For Curative Resection Of Adenocarcinoma Of The Left Pancreas

Objective To introduce radical antegrade modular pancreatosplenectomy for curative resection of adenocarcinoma of the left pancreas.Methods We retrospectively analyzed 40 patients of distal pancreatic cancer who underwent pancreatosplenectomy from January 2010 to January 2015.20 patients underwent radical antegrade modular pancreatosplenectomy.20 patients underwent standard pancreatosplenectomy.We compared the clinicopathologic factors and oncologic outcomes including blood loss,operative time,the rate of complication and5-year survival.Results There were no significant differences in operative time(RAMPS 191±65.3min vs.standard pancreatosplenectomy 181 ±54.2min,p=0.6013),blood loss(RAMPS 164±78.1ml vs.standard pancreatosplenectomy 153±68.1ml,p=0.6377),intraoperative transfusion(RAMPS 2/20 vs.standard pancreatosplenectomy1/20,p=0.5480),hospital stay(RAMPS 15.6 ±8.2 days vs.standard pancreatosplenectomy 14.3 ±7.8 days,p=0.6104),pancreatic fistula((p=0.834),delay gastric emptying(p=0.633)and postoperative bleeding(p=0.548)between two groups.The R0 rate and retrieved lymph nodes were significant higher in RAMPS group(p=0.0416,p=0.0280).The RAMPS group had longer overall survival than standard group(p=0.0280).Conclusion for curative resection of adenocarcinoma of the left pancreas is favor ofthe dissection of the posterior pancreatic surface,which is safe and feasible.Moreover,it may increase the rate of R0 and the number of retrieved lymph nodes.