Periadventitial dissection of the superior mesenteric artery for locally advanced pancreatic cancer: Surgical planning with the “halo sign” and “string sign”

医学 形状记忆合金* 肠系膜上动脉 胰腺癌 放射科 外科 解剖(医学) 癌症 内科学 数学 组合数学
作者
Joseph R. Habib,Benedict Kinny‐Köster,Floortje van Oosten,Ammar A. Javed,John L. Cameron,Kelly J. Lafaro,Richard A. Burkhart,William R. Burns,Jin He,Elizabeth D. Thompson,Elliot K. Fishman,Christopher L. Wolfgang
出处
期刊:Surgery [Elsevier]
卷期号:169 (5): 1026-1031 被引量:43
标识
DOI:10.1016/j.surg.2020.08.031
摘要

Most patients diagnosed with pancreatic cancer are classified as nonoperative candidates based on the contemporary guidelines of resectability. The advent of more potent control of systemic disease using neoadjuvant chemotherapy has enabled more aggressive operative interventions. In our multidisciplinary practice, patients with Stage III, locally advanced pancreatic cancer and superior mesenteric artery (SMA) encasement are now carefully triaged with high quality, preoperative imaging to determine if they can be considered candidates for operative resection with periadventitial dissection of the SMA. Patients displaying a "halo sign," where the encased SMA remains fully patent and free from arterial invasion, are now candidates for SMA periadventitial dissection. This procedure involves the surgical stripping of the infiltrated neurolymphatic tissue off the SMA leaving behind a bare "skeletonized artery." Alternatively, the "string sign" involving the SMA confers a more likely case of arterial invasion, where a complete oncologic resection cannot be achieved successfully. This method of patient selection in case of SMA involvement abandons the traditional metrics of circumferential degrees of the arterial encasement to guide surgical decisions. Our institutional approach has allowed us to meaningfully expand our operative methods of resection with the potential for improved longitudinal outcomes to pancreatic cancer patients who were deprived historically from the more effective and possibly curative treatment.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
大幅提高文件上传限制,最高150M (2024-4-1)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
hardworkcd发布了新的文献求助10
刚刚
SHENJINBING发布了新的文献求助30
1秒前
1秒前
2秒前
夜守发布了新的文献求助10
2秒前
深情安青应助辛勤幻梅采纳,获得30
4秒前
5秒前
5秒前
Fen完成签到,获得积分10
6秒前
潘宇霜发布了新的文献求助20
6秒前
筱悠给筱悠的求助进行了留言
7秒前
胖虎啊发布了新的文献求助10
9秒前
qqqqgc发布了新的文献求助10
11秒前
11秒前
11秒前
lilili完成签到,获得积分20
12秒前
14秒前
逍遥庄完成签到,获得积分10
14秒前
eghiefefe完成签到,获得积分10
14秒前
hardworkcd完成签到,获得积分10
15秒前
胖虎啊完成签到,获得积分10
16秒前
情怀应助qqqqgc采纳,获得10
16秒前
Xiexie发布了新的文献求助10
17秒前
kk7u发布了新的文献求助10
18秒前
海绵baobao完成签到,获得积分10
18秒前
19秒前
panpan完成签到 ,获得积分10
20秒前
良辰应助Ziming采纳,获得10
21秒前
善学以致用应助xx采纳,获得10
21秒前
海绵baobao发布了新的文献求助10
21秒前
22秒前
22秒前
鉴定为学计算学的完成签到,获得积分10
22秒前
菜菜的黄完成签到,获得积分20
23秒前
凌寻绿完成签到,获得积分10
23秒前
tuanheqi应助shw采纳,获得20
25秒前
25秒前
南部之星琪完成签到,获得积分20
25秒前
萌仔防守完成签到,获得积分10
26秒前
chen完成签到,获得积分10
26秒前
高分求助中
Evolution 10000
Sustainability in Tides Chemistry 2800
The Young builders of New china : the visit of the delegation of the WFDY to the Chinese People's Republic 1000
юрские динозавры восточного забайкалья 800
English Wealden Fossils 700
Foreign Policy of the French Second Empire: A Bibliography 500
Chen Hansheng: China’s Last Romantic Revolutionary 500
热门求助领域 (近24小时)
化学 医学 生物 材料科学 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 基因 遗传学 催化作用 物理化学 免疫学 量子力学 细胞生物学
热门帖子
关注 科研通微信公众号,转发送积分 3146344
求助须知:如何正确求助?哪些是违规求助? 2797778
关于积分的说明 7825411
捐赠科研通 2454118
什么是DOI,文献DOI怎么找? 1306100
科研通“疑难数据库(出版商)”最低求助积分说明 627638
版权声明 601503