論文種別	原著(症例報告除く)
言語種別	英語
査読の有無	その他(不明)
表題	Long-term outcomes of prophylactic right-half dissection of the superior mesenteric artery nerve plexus in pancreatoduodenectomy for pancreatic ductal adenocarcinoma: five-year results from a randomized phase II trial.
掲載誌名	正式名：Surgery today 略　 称：Surg Today ISSNコード：14362813/09411291
掲載区分	国外
巻・号・頁	pp.Online ahead of print
著者・共著者	Yuki Matsui, Daisuke Hashimoto, Nobuhiko Nakagawa, So Yamaki, Masamichi Hayashi, Hideki Takami, Kazuto Shibuya, Suguru Yamada, Sohei Satoi, Tsutomu Fujii
発行年月	2025/05
概要	PURPOSES:In pancreaticoduodenectomy for pancreatic ductal adenocarcinoma (PDAC), Prophylactic right-half dissection of the superior mesenteric artery (SMA) nerve plexus has been attempted in pancreaticoduodenectomy for pancreatic ductal adenocarcinoma. In this study, we evaluated the significance of prophylactic right-half dissection of the SMA nerve plexus by extending the observation period to 5 years.METHODS:From April 2014 to June 2018, 74 patients with PDAC in the pancreatic head were randomly assigned to either the dissection group, in which the right half of the nerve plexus of the SMA was dissected (n = 37) or the preservation group, in which the nerve plexus of the SMA was completely preserved (n = 37). The 5-year relapse-free survival (RFS), overall survival (OS), and incidence of diarrhea were prospectively compared between groups.RESULTS:The median RFS (20 vs. 16 months, P = 0.503) and OS (37.0 vs. 30.0 months, P = 0.582) did not differ significantly between the dissection and preservation groups. There was no significant difference in locoregional recurrence (27.0% vs. 37.8%, P = 0.320) or distant metastasis (64.9% vs. 83.0%, P = 0.451). Postoperative diarrhea occurred in 64.9% and 62.2% of the cases in the dissection and preservation groups, respectively (P = 0.809).CONCLUSION:Prophylactic right half dissection of the SMA nerve plexus did not improve the RFS or OS.
DOI	10.1007/s00595-025-03062-6
PMID	40380996