Comparison of minimal invasive versus open radical antegrade modular pancreatosplenectomy (RAMPS) for pancreatic ductal
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and Other Interventional Techniques
Comparison of minimal invasive versus open radical antegrade modular pancreatosplenectomy (RAMPS) for pancreatic ductal adenocarcinoma: a single center retrospective study Hanyu Zhang1 · Yatong Li1 · Quan Liao1 · Cheng Xing1 · Cheng Ding1 · Taiping Zhang1 · Junchao Guo1 · Xianlin Han1 · Qiang Xu1 · Wenming Wu1 · Yupei Zhao1 · Menghua Dai1 Received: 19 May 2020 / Accepted: 25 August 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Introduction Radical antegrade modular pancreatosplenectomy (RAMPS) was proposed a decade ago with the aim to achieve higher R0 tangential margin and radical N1 lymph node resection for left-sided pancreatic adenocarcinoma (PDAC), which has been widely accepted worldwide at present. Laparoscopic RAMPS (Lap-RAMPS) has been attempted for PDAC during last several years, however, no outcomes evaluation by comparison between laparoscopic vs open RAMPS has been reported yet. Materials and methods From August, 2012 to March, 2018, patients undergoing open or lap-RAMPS for the diagnosis of left-sided PDAC were reviewed from a prospective database. Patients excluded if they were related with combined organs or vessels resection, systematic metastasis as well as conversion from open RAMPS to lap RAMPS. The surgical and oncologic outcomes were compared. Results A total of 48 PDAC patients were enrolled (25 underwent lap-RAMPS and 23 underwent open-RAMPS). There were no significant differences in demographic or perioperative morbidity. In the lap-RAMPS group, R0 transection margin and retroperitoneal margin were both achieved in 23 of 25 patients (92%). In the open RAMPS group, R0 transection margin was achieved in 21 of 23 patients (91.3%), R0 retroperitoneal margin was 22 of 23 patients (95.65%). There were no differences in pathological examinations. The number of lymph node (LN) retrieved between lap-RAMPS and open- RAMPS group was not significant difference (15.84 vs 18.22; P = 0.268). Median disease-free survival (DFS) was analogous in two groups (18.11 m vs 20.00 m, P = 0.999). Median overall survival (OS) was 24.53 m in lap-RAMPS group and 28.73 m in the open-RAMPS group (P = 0.633). Conclusions Lap-RAMPS is technically feasible, and has comparable long-term oncological outcome with open-RMAPS. Keywords Pancreatic cancer · Minimal invasive surgery · Radical antegrade modular pancreatosplenectomy · RAMPS · Laparoscopic distal pancreatectomy PDAC is an extremely lethal disease in human, which is the fourth leading cause of cancer-related deaths in the USA [1]. PDAC of the body and tail usually remains asymptomatic until late in the disease course. Thus, patients often have Hanyu Zhang and Yatong Li have contributed equally to this work. * Menghua Dai [email protected] 1
Department of General Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 1, Shuai Fu Yuan, Dongcheng District, Beijing 100730, China
advanced disease and even metastasis at the tim
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