Lyadov V K, Milovanov V V
Treatment and Rehabilitation Center of Russian Ministry of Health Care; Russian Medical Academy of Postgraduate Education, Moscow, Russia.
Russian Medical Academy of Postgraduate Education, Moscow, Russia.
Khirurgiia (Mosk). 2016(12):93-97. doi: 10.17116/hirurgia20161293-97.
To summarize the data of 'no-touch isolation technique' (NIT) for pancreatoduodenectomy and radical antegrade modular pancreato-splenectomy (RAMPS) for pancreatic malignancies.
We looked through Pubmed and Cochrane databases for scientific papers published from January 2000 until September 2014.
Eight studies were included. There were 7 retrospective cohort studies and one randomized controlled trial (RCT). Mean operation time and blood loss were 267 min (198-386 min) and 132 ml (331-744 ml) respectively. Mean morbidity rate was 35% (17-58%). There was no 30-day mortality. Mean incidence of R0-resection varied from 50% to 97% with average value 84%. Median survival was reported in 3 studies (17, 18 and 26 months). Five-year actuarial overall survival was reported in 4 studies (31, 36, 40 and 53%).
Positive results of NIT and RAMPS might justify further evaluation of the method in pancreatic cancer. Prospective randomized controlled trials needs to be done to demonstrate the oncological value of this novel surgical technique.
总结胰十二指肠切除术的“非接触隔离技术”（NIT）以及胰腺恶性肿瘤根治性顺行模块化胰脾切除术（RAMPS）的数据。
我们查阅了Pubmed和Cochrane数据库，以获取2000年1月至2014年9月发表的科学论文。
纳入八项研究。其中有七项回顾性队列研究和一项随机对照试验（RCT）。平均手术时间和失血量分别为267分钟（198 - 386分钟）和132毫升（33 - 744毫升）。平均发病率为35%（17 - 58%）。无30天死亡率。R0切除的平均发生率在50%至97%之间，平均值为84%。三项研究报告了中位生存期（17、18和26个月）。四项研究报告了五年精算总生存率（31%、36%、40%和53%）。
NIT和RAMPS的阳性结果可能证明有必要对该方法在胰腺癌中的应用进行进一步评估。需要开展前瞻性随机对照试验来证明这种新型手术技术的肿瘤学价值。
