[Analgesic effect of transhiatal splanchnectomy in pain from cancer of the pancreas. Apropos of 51 operated cancers].
The greater splanchnic nerves are responsible for sympathetic innervation of the supra mesocolic viscera, and total bilateral neurotomy is efficient to relieve pancreatic pain. Their dissection is easy by a midline transperitoneal route used for pancreatic cancer surgery. The aim of this study was to evaluate the pain relief related to transhiatal bilateral splanchnicotomy in patients with pancreatic cancer. The tumor was unresectable for all the patients, and nobody was operated only to make neurotomy. Twenty two patients had single bilateral splanchnicotomy, and other had an associated biliary and/or digestive diversion. There was not postoperative specific mortality, and postoperative mortality rate was 3.9%. Specific postoperative morbidity rate was 6%. Most of the patients (83.3%) had immediate pain relief, with or without diversion (respectively 80.7% and 86.3%, p = 0.6). Our data suggest that pain recurs for some patients three months after surgery (pain control in respectively 69.2% and 72.7%), but difference was not significant (p = 0.14). Our results demonstrate that transhiatal bilateral splanchnicotomy relieves pain in patients with pancreatic cancer, with a poor specific morbidity.
Sielezneff
I
I
Service de Chirurgie Générale et Digestive, Hôpital Sainte-Marguerite, Marseille.
Sastre
B
B
Crespy
B
B
Carabalona
B
B
Delpero
J R
JR
Michotey
G
G
D000230:Adenocarcinoma / Q000150:complications* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015904:Biliopancreatic Diversion; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary; D008297:Male; D008875:Middle Aged; D010148:Intractable Pain / Q000209:etiology / Q000601:surgery*; D010149:Postoperative Pain / Q000601:surgery; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D010534:Peritoneal Neoplasms / Q000556:secondary; D013153:Splanchnic Nerves / Q000601:surgery*
L'effet antalgique de la splanchnicectomie trans-hiatale dans les douleurs du cancer du pancréas. A propos de 51 cancers opérés.