Эмбрионально-ориентированная хирургия рака головки поджелудочной железы
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Ключевые слова

mesopancreas
Artery-first approach
мезопанкреас
рак головки поджелудочной железы
панкреатодуоденальная резекция

Аннотация

Введение. Более чем у половины больных раком головки поджелудочной железы (РГПЖ) на момент постановки диагноза имеется местнораспространенная опухоль и/или отдаленные гематогенные метастазы. Таким образом, прогноз у большинства таких пациентов неблагоприятный, с 5-летней выживаемостью 8% на всех стадиях. Текущее десятилетие стало свидетелем бурной эволюции в хирургии поджелудочной железы, в частности, по сравнению с классическим подходом к панкреатодуоденальной резекции (ПДР) стали появляться альтернативные варианты, такие как Artery-first approach, Total Mesopancreas Excision (TMpE), No-touch approach ― все перечисленные методы своей главной целью ставят повышение резектабильности, частоты выполнения R0-резекции и улучшение отдаленных онкологических результатов. На основании проанализированной литературы мы пришли к выводу, что увеличение объема оперативного вмешательства у больных раком поджелудочной железы не улучшает онкологические результаты. Расширенная лимфодиссекция не продемонстрировала преимуществ в метаанализах. Отсутствуют исследования, доказывающие эффективность и целесообразность выполнения мезопанкреасэктомии.
https://doi.org/10.37469/0507-3758-2022-68-5-555-564
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Copyright (c) 2022 Илья Вервекин, Антон Трушин, Роман Курсенко , Данила Зайцев , Михаил Беляев , Александр Захаренко