Background: Laparoscopic surgery has been performed less frequently in the era of pancreatic cancer due to\ntechnical difficulties and concerns about oncological safety. Radical antegrade modular pancreatosplenectomy\n(RAMPS) is expected to be helpful to obtain a negative margin during radical lymph node dissection. We\nhypothesized that it would also be favorable as a laparoscopic application due to unique features.\nMethods: Fifteen laparoscopic RAMPS for well-selected patients with left-sided pancreatic cancer were performed\nfrom July 2011 to April 2016. Five trocars were usually used, and the operative procedures and range of dissection\nwere similar to or the same as those of open RAMPS described by Strasberg. All medical records and follow-up data\nwere reviewed and analyzed.\nResults: All patients had pancreatic ductal adenocarcinoma. Mean operative time was 219.3 �± 53.8 min, and\nestimated blood loss was 250 �± 70 ml. The length of postoperative hospital stay was 6.1 �± 1.2 days, and\npostoperative morbidities developed in two patients (13.3%) with urinary retention. The median number of\nretrieved lymph nodes was 18.1 �± 6.2 and all had negative margins. Median follow-up time was 46.0 months, and\nthe 3-year disease free survival and overall survival rates were 56.3% and 74.1%, respectively.\nConclusion: Our early experience with laparoscopic RAMPS achieved feasible perioperative results accompanied by\nacceptable survival outcomes. Laparoscopic RAMPS could be a safe and oncologically feasible procedure in wellselected\npatients with left-sided pancreatic cancer.
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