title: Inframesocolic Superior Mesenteric Artery First Approach as an Introductory Procedure of Radical Antegrade Modular Pancreatosplenectomy for Carcinoma of the Pancreatic Body and Tail.
abstract: Superior mesenteric artery (SMA)-first approaches are operative tactics used to determine tumor resectability early during pancreatoduodenectomy. With locally advanced carcinoma of the pancreatic body and tail, early determination of SMA involvement also helps establish whether curative resection is feasible. During either radical antegrade modular pancreatosplenectomy (RAMPS) or classic left-to-right distal pancreatectomy, dissection of the SMA is performed after transection of the pancreas or wide detachment of the distal pancreas and spleen. Herein, we describe an inframesocolic SMA-first approach as an introductory procedure when treating carcinoma of the pancreatic body and tail. This first approach procedure provides a reliable and safe introduction to RAMPS.
authors.affiliation: Department of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan. suaosasa@ndmc.ac.jp.
authors.forename: Suefumi
authors.initials: S
authors.lastname: Aosasa
authors.affiliation: Department of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Nishikawa
authors.affiliation: Department of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Hoshikawa
authors.affiliation: Department of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan.
authors.forename: Takuji
authors.initials: T
authors.lastname: Noro
authors.affiliation: Department of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan.
authors.forename: Junji
authors.initials: J
authors.lastname: Yamamoto
mesh_terms: D002277:Carcinoma / Q000473:pathology / Q000601:surgery*; D004210:Dissection / Q000379:methods*; D006801:Humans; D017538:Mesenteric Artery, Superior / Q000601:surgery*; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery*; D013156:Splenectomy / Q000379:methods*
keywords: Distal pancreatectomy; Pancreatic cancer; Superior mesenteric artery