Mesopancreas:A boundless structure,namely the rationale for dissection of the paraaortic area in pancreaticoduodenectomy for pancreatic head carcinoma

作     者：Nadia Peparini 

作者机构：Azienda Sanitaria Locale Roma H- Distretto 300043 Ciampino (Rome)Italy 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2015年第21卷第10期

页      面：2865-2870页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Pancreatic carcinoma Mesopancreas Mesopancreas res 

摘      要：This review highlights the rationale for dissection of the 16a2 and 16b1 paraaortic area during pancreaticoduodenectomy(PD)for carcinoma of the head of the *** advances in surgical anatomy of the mesopancreas indicate that the retropancreatic area is not a single entity with well defined boundaries but an anatomical site of embryological fusion of peritoneal layers,and that continuity exists between the neuro lymphovascular adipose tissues of the retropancreaticand paraaortic *** advances in surgical pathology and oncology indicate that,in pancreatic head carcinoma,the mesopancreatic resection margin is the primary site for R1 resection,and that epithelialmesenchymal transition-related processes involved in tumor progression may impact on the prevalence of R1 resection or local recurrence rates after R0 *** concepts imply that mesopancreas resection during PD for pancreatic head carcinoma should be extended to the paraaortic area in order to maximize retropancreatic clearance and minimize the likelihood of an R1 resection or the persistence of residual tumor cells after R0 *** PD for pancreatic head carcinoma,the rationale for dissection of the paraaortic area is to control the spread of the tumor cells along the mesopancreatic resection margin,rather than to control or stage the nodal *** mesopancreatic resection cannot be consideredcompleteoren bloc,it should beextended as far as possibleor bemaximal,including dissection of16a2 and 16b1 paraaortic areas.