title: Outcomes from mesenteric-portal axis resection during pancreatectomy.
abstract: BACKGROUND
  Due to their complexity and risks, mesenteric-portal axis resection and reconstruction during the pancreatectomy procedure were not recommended back in the early nineties. However, as per technical improvements and the reduction in morbidity and mortality rates, they have been routinely indicated in large medical centers.
  
  
  OBJECTIVE
  To show results from cases of patients subjected to mesenteric-portal axis resection during pancreatectomy.
  
  
  METHODS
  Patients subjected to mesenteric-portal axis resection during pancreatectomy were prospectively and consecutively assessed. The procedure was indicated according to anatomical criteria defined by imaging exams or intraoperative assessment.
  
  
  RESULTS
  Ten patients, half of them were male, with mean age of 55.7 years (40-76) were included. The most frequent underlying diseases were pancreatic adenocarcinoma and Frantz tumor. The circumferential resection of the portal vein associated with the superior mesenteric vein with splenic vein ligature (4 cases=40%) and the primary anastomosis of the vascular stumps (5 cases=50%) were, respectively, the most performed types of vascular resection and reconstruction. Surgery time ranged from 480 to 600 minutes (average=556 minutes) and postoperative hospitalization time ranged from 9 to 114 days (average=34.8 days). Morbidity rate was 60%, and clinical pancreatic fistula (grade B and C) was the most common complication (3 cases=30%). Mortality rate was 10% (1 case).
  
  
  CONCLUSIONS
  Mesenteric-portal axis resection is a valid technical procedure. It should be taken into account after a clinical assessment that included not only the patients' clinical condition but also the technical and anatomical conditions of the mesenteric-portal axis tumor infiltration as well as life expectancy based on the patient's cancer prognosis.
authors: Hospital Universitário Onofre Lopes, Universidade Federal do Rio Grande do Norte.
authors: Enio Campos
authors: EC
authors: Amico
authors: Hospital Universitário Onofre Lopes, Universidade Federal do Rio Grande do Norte.
authors: José Roberto
authors: JR
authors: Alves
authors: Hospital Universitário Onofre Lopes, Universidade Federal do Rio Grande do Norte.
authors: Samir Assi
authors: SA
authors: João
authors: Hospital Universitário Onofre Lopes, Universidade Federal do Rio Grande do Norte.
authors: Ricardo Wagner da Costa
authors: RW
authors: Moreira
authors: Liga Norte-Riograndense contra o Câncer.
authors: José Linhares
authors: JL
authors: da Silva Neto
authors: Hospital Universitário Onofre Lopes, Universidade Federal do Rio Grande do Norte.
authors: Joafran Alexandre Costa
authors: JA
authors: de Medeiros
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008642:Mesenteric Veins / Q000601:surgery*; D008875:Middle Aged; D010180:Pancreatectomy / Q000379:methods*; D011169:Portal Vein / Q000601:surgery*; D011446:Prospective Studies; D016896:Treatment Outcome
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