title: Ex-vivo Resection and Small-Bowel Auto-transplantation for the Treatment of Tumors at the Root of the Mesentery.
abstract: BACKGROUND
  Tumors involving the root of the mesentery are generally regarded as "unresectable" with conventional surgical techniques. Resection with conventional surgery may end in life-threatening complications in these patients. Ex-vivo resection and auto-transplantation avoids excessive bleeding and prevents ischemic related damage to the small intestine and other organs.
  
  
  OBJECTIVE
  To share our experience of ex-vivo resection of the tumors with involvement of small bowel mesentery followed by small bowel auto-transplantation.
  
  
  METHODS
  In this study, medical records of all the patients who underwent ex-vivo resection and auto-transplantation at our center were retrospectively analyzed.
  
  
  RESULTS
  The most common indication for the procedure in our series was locally advanced pancreatic carcinoma. Our survival rate was 50% with a mean±SD follow-up of 10.1±9.8 (range: 0-26) months. Causes of early in-hospital mortality were multi-organ failure, sepsis, and cerebrovascular accident. Recurrence of disease was noted in one patient while one patient developed hepatic metastasis after 20 months of surgery.
  
  
  CONCLUSIONS
  Ex-vivo resection of the tumor and auto-transplantation is the surgical treatment of choice for the locally advanced abdominal tumors involving the root of the mesentery.
authors.affiliation: Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: S
authors.initials: S
authors.lastname: Nikeghbalian
authors.affiliation: Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran ; Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: M
authors.initials: M
authors.lastname: Aliakbarian
authors.affiliation: Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: K
authors.initials: K
authors.lastname: Kazemi
authors.affiliation: Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: A R
authors.initials: AR
authors.lastname: Shamsaeefar
authors.affiliation: Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: S H
authors.initials: SH
authors.lastname: Mehdi
authors.affiliation: Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: A
authors.initials: A
authors.lastname: Bahreini
authors.affiliation: Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: S A
authors.initials: SA
authors.lastname: Malek-Hosseini
keywords: Auto-transplantation; Ex-vivo resection; Intestine; Mesentery; Mortality; Neoplasms; small