title: Total meso-pancreas excision: key point of resection in pancreatic head adenocarcinoma.
abstract: Pancreatic head cancer is a disease with a dismal prognosis, even after curative intent surgery, Resection represents the only hope for long-term survival. The negative resection margins (R0 resection) represent a strong independent prognostic factor. Up to 80% of so-called curative resections are, in fact, non-curative (with microscopically positive margins). The area most involved in positive resection margins is the meso-pancreas. Thus, the local recurrence is up to 80% within one year after resection. The term meso-pancreas was recently proposed to emphasize this area's role in positive resection margins, local recurrence after pancreatoduodenectomy and prognosis. Total meso-pancreas excision is presumed to decrease the rate of R1 resection and improve survival and is facilitated by a posterior/artery first approach.
authors.affiliation: Center of General Surgery and Liver Transplantation, Fundeni Clinical Institute, Fundeni Street no. 258, 022328, Bucharest, Romania. irinel.popescu220@gmail.com
authors.forename: Irinel
authors.initials: I
authors.lastname: Popescu
authors.forename: Traian
authors.initials: T
authors.lastname: Dumitrascu
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D006801:Humans; D009364:Neoplasm Recurrence, Local; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D015996:Survival Rate; D016896:Treatment Outcome