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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 1/2018

01-01-2018 | Pancreatic Tumors

Role of Radical Antegrade Modular Pancreatosplenectomy (RAMPS) and Pancreatic Cancer

Author: Yun Shin Chun, MD, FACS

Published in: Annals of Surgical Oncology | Issue 1/2018

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Abstract

Purpose

Conventional retrograde distal pancreatectomy and splenectomy for pancreatic adenocarcinoma of the body and tail have been associated with high rates of positive margins, low lymph node retrieval, and poor overall survival. Radical antegrade modular pancreatosplenectomy (RAMPS) was introduced in 2003 to overcome these limitations.

Methods

A systematic literature search was performed and articles reviewed to determine if RAMPS or standard distal pancreatectomy and splenectomy offer better survival. The level of evidence was assessed using the Grades of Recommendation, Assessment, Development, and Evaluation system.

Results

Retrospective, single-institution series on RAMPS report mean lymph node counts as high as 24, and negative margin rates between 81 and 100%. Tangential margins are reportedly negative in 94% of patients undergoing RAMPS. Studies comparing RAMPS with standard distal pancreatectomy and splenectomy demonstrate significantly higher lymph node counts, but no improvement in overall survival with RAMPS.

Conclusion

Despite the theoretic advantages of RAMPS over standard resection, high-level evidence that demonstrates a survival benefit with RAMPS does not currently exist.
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Metadata
Title
Role of Radical Antegrade Modular Pancreatosplenectomy (RAMPS) and Pancreatic Cancer
Author
Yun Shin Chun, MD, FACS
Publication date
01-01-2018
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 1/2018
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5675-4

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