Department of Surgery, Kumamoto Regional Medical Center, 5-16-10 Honjo, Kumamoto City, Kumamoto 860-0811, Japan.
Am J Surg. 2010 May;199(5):e65-8. doi: 10.1016/j.amjsurg.2008.06.035. Epub 2008 Dec 18.
Pancreatoduodenectomy is the only effective treatment for cancers of the periampullary region. Because surgeons usually grasp tumors during pancreatoduodenectomy, this procedure may increase the risk of squeezing and shedding the cancer cells into the portal vein, retroperitoneum, and/or peritoneal cavity. In an effort to overcome these problems, we have developed a surgical technique for no-touch pancreatoduodenectomy.
From March 2005 through May 2008, 42 patients have been operated on following this technique. Resected margins were microscopically analyzed.
We describe a technique for pancreatoduodenectomy using a no-touch isolation technique. We resect cancers with wrapping them within Gerota's fascia and transect the retroperitoneal margin along the right surface of the superior mesenteric artery and abdominal aorta without grasping tumors.
No-touch pancreatoduodenectomy has many potential advantages that merit further investigation in future randomized controlled trials.
胰十二指肠切除术是治疗壶腹周围区域癌症的唯一有效方法。由于外科医生通常在胰十二指肠切除术中抓住肿瘤，因此该手术可能会增加将癌细胞挤压和脱落到门静脉、腹膜后和/或腹腔中的风险。为了克服这些问题，我们开发了一种无接触胰十二指肠切除术的手术技术。
从 2005 年 3 月到 2008 年 5 月，我们采用这种技术对 42 名患者进行了手术。对切除的边缘进行了显微镜分析。
我们描述了一种使用无接触隔离技术的胰十二指肠切除术技术。我们通过将癌症包裹在格罗塔筋膜内来切除癌症，并沿着肠系膜上动脉和腹主动脉的右侧表面横断腹膜后边缘，而不抓肿瘤。
无接触胰十二指肠切除术具有许多潜在的优势，值得在未来的随机对照试验中进一步研究。
