Pancreatic cancer
Conditions
Interventions
In the conventional procedure group, first, the pancreatic body and tail and spleen are mobilized (mandatory procedure), and the regional lymph nodes of the body and tail of the pancreas, such as the
Sponsors
Wakayama Medical University
Clinical Study Support Center, Wakayama Medical University Hospital
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1) Resectable pancreatic cancer (Adenocarcinoma, adenosquamous cell carcinoma, mucinous carcinoma, and anaplastic carcinoma according to the 7th edition of the regulations for handling pancreatic cancer, excluding invasive intraductal papillary mucinous carcinoma (IPMC). However, preoperative biopsy. Is not required and allows clinical diagnosis), and a tail pancreatectomy or tail pancreatectomy is planned. 2) ASA-PS (American Society of Anesthesiology, General condition classification) is Class 1-3. 3) Age are over 20 years old. 4) He/she has sufficient judgment to understand the content of the research and has obtained written consent from the person himself/herself.
Exclusion criteria
Exclusion criteria: 1) Patients who have not been diagnosed with resectable pancreatic cancer by image diagnosis at the initial diagnosis 2) Cases suspected of portal vein (superior mesenteric vein) invasion 3) Patients with severe ischemic heart disease 4) Patients with cirrhosis or active hepatitis requiring treatment 5) Patients with dyspnea requiring oxygen administration 6) Patients undergoing dialysis due to chronic renal failure 7) Cases in which arterial reconstruction of the superior mesenteric artery, common hepatic artery, celiac artery, etc. is considered necessary 8) Patients with strong suspected paraaortic lymph node metastasis 9) Active double cancer thought to affect adverse events and prognosis 10) Long-term oral steroids that may affect adverse events 11) Patients who are considered to have difficulty participating in the study due to psychosis or psychiatric symptoms. 12) Cases other than invasive pancreatic ductal carcinoma by preoperative biopsy. Invasive pancreatic ductal carcinoma is classified into four types, adenocarcinoma, adenosquamous cell carcinoma, mucinous carcinoma, and anaplastic carcinoma, in accordance with the 7th edition of the regulations for handling pancreatic cancer, and invasive intraductal papillary mucinous carcinoma (IPMC) is excluded. (However, preoperative biopsy is not mandatory.) 13) Patients who cannot use both iodine drugs and gadnium drugs due to severe drug allergy 14) Cases where the prescribed procedure is difficult due to history of upper abdominal surgery such as stomach, spleen, kidney, liver, transverse colon, retroperitoneum including pancreas and pancreatitis
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 2-year recurrence-free survival | — |
Secondary
| Measure | Time frame |
|---|---|
| Surgical data: Surgery time, blood loss, blood transfusion Postoperative complications: Incidence of each Grade of pancreatic fistula, Incidence of delayed gastric excretion (DGE) Grade B/C, Incidence of intraperitoneal hemorrhage (PPH) Grade B/C, Incidence of all postoperative complications, Surgical death Proportion Pathological diagnosis: ratio of tumor residual rate (R0, R1 rate), total number of resected lymph nodes, number of metastatic lymph nodes, lymph node ratio (number of metastatic lymph nodes/total number of resected lymph nodes) Treatment results: Overall survival, recurrence-free survival, local recurrence rate | — |
Countries
Japan
Contacts
Public ContactKen-ichi Okada
Wakayama Medical University Second Department of Surgery
Outcome results
None listed