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Komarov R.N.

Sechenov First Moscow State Medical University

Egorov A.V.

Sechenov First Moscow State Medical University

Osminin S.V.

Sechenov First Moscow State Medical University

Bilyalov I.R.

Sechenov First Moscow State Medical University

Zhemerikin G.A.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Ryabov K.Yu.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Novikov S.S.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

The first experience of small intestinal autotransplantation for advanced digestive cancer

Authors:

Komarov R.N., Egorov A.V., Osminin S.V., Bilyalov I.R., Zhemerikin G.A., Ryabov K.Yu., Novikov S.S.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2023;(12): 34‑42

DOI: 10.17116/hirurgia202312134

Views: 1101

Downloaded: 12

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Table of contents

To cite this article:

Komarov RN, Egorov AV, Osminin SV, Bilyalov IR, Zhemerikin GA, Ryabov KYu, Novikov SS. The first experience of small intestinal autotransplantation for advanced digestive cancer. Pirogov Russian Journal of Surgery. 2023;(12):34‑42. (In Russ.)
https://doi.org/10.17116/hirurgia202312134

Подписка 2025 (Pirogov Russian Journal of Surgery)
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Usually, gastrointestinal tumors (GIT) invading great vessels are acknowledged to be irresectable. Along with that, we can expect positive oncological results only when there is combination treatment with radical surgery (R0 resection). In this article we share the first experience of small intestinal autotransplantation as a method of radical surgery in locally advanced GIT. We conducted the analysis of outcomes of three patients (with pancreas cancer (n=2) and neuroendocrine tumor of caecum (n=1), with neoplastic process involving to superior mesenteric artery and vein. We analyzed intraoperative aspects and algorithm of small intestinal autotransplantation. Long-term outcomes with 1.5—13 months of observing time are presented. On the basis of conducted analysis the authors suggest the possibility of small intestinal autotransplantation in referral centers with strict personalized approach and multidisciplinary surgical team.

Keywords:

small intestinal autotransplantation
pancreas cancer
neuroendocrine tumor
vessel reconstruction

Authors:

Komarov R.N.

Sechenov First Moscow State Medical University

Egorov A.V.

Sechenov First Moscow State Medical University

Osminin S.V.

Sechenov First Moscow State Medical University

Bilyalov I.R.

Sechenov First Moscow State Medical University

Zhemerikin G.A.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Ryabov K.Yu.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Novikov S.S.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Received:

13.05.2022

Accepted:

20.10.2022

List of references:

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  2. Gemici K, Buldu İ, Acar T, Alptekin H, Kaynar M, Tekinarslan E, Karatağ T, Efe D, Çolak H, Küçükkartallar T, İstanbulluoğlu MO. Management of patients with retroperitoneal tumors and a review of the literature. World Journal of Surgical Oncology. 2015;13:143.  https://doi.org/10.1186/s12957-015-0548-z
  3. Varadhachary GR, Tamm EP, Abbruzzese JL, Xiong HQ, Crane CH, Wang H, Lee JE, Pisters PW, Evans DB, Wolff RA. Borderline resectable pancreatic cancer: definitions, management, and role of preoperative therapy. Annals of Surgical Oncology. 2006;13(8):1035-106.  https://doi.org/10.1245/ASO.2006.08.011
  4. Del Chiaro M, Rangelova E, Halimi A, Ateeb Z, Scandavini C, Valente R, Segersvärd R, Arnelo U, Verbeke CS. Pancreatectomy with arterial resection is superior to palliation in patients with borderline resectable or locally advanced pancreatic cancer. HPB. 2019;21(2):219-225.  https://doi.org/10.1016/j.hpb.2018.07.017
  5. Shaib Y, Davila J, Naumann C, El-Serag H. The impact of curative intent surgery on the survival of pancreatic cancer patients: a U.S. Population-based study. American Journal of Gastroenterology. 2007;102(7):1377-1382. https://doi.org/10.1111/j.1572-0241.2007.01202.x
  6. Del Chiaro M, Segersvärd R, Rangelova E, Coppola A, Scandavini CM, Ansorge C, Verbeke C, Blomberg J. Cattell-Braasch Maneuver Combined with Artery-First Approach for Superior Mesenteric-Portal Vein Resection During Pancreatectomy. Journal of Gastrointestinal Surgery. 2015;19(12):2264-2268. https://doi.org/10.1007/s11605-015-2958-1
  7. Kleive D, Sahakyan MA, Berstad AE, Verbeke CS, Gladhaug IP, Edwin B, Fosby B, Line PD, Labori KJ. Trends in indications, complications and outcomes for venous resection during pancreatoduodenectomy. British Journal of Surgery. 2017;104(11):1558-1567. https://doi.org/10.1002/bjs.10603
  8. Jegatheeswaran S, Baltatzis M, Jamdar S, Siriwardena AK. Superior mesenteric artery (SMA) resection during pancreatectomy for malignant disease of the pancreas: a systematic review. HPB. 2017;19(6):483-490.  https://doi.org/10.1016/j.hpb.2017.02.437
  9. Lai DT, Chu KM, Thompson JF, Gallagher JP, Waugh R, Storey DW, Stephen MS. Islet cell carcinoma treated by induction regional chemotherapy and radical total pancreatectomy with liver revascularization and small bowel autotransplantation. Surgery. 1996;119(1):112-114.  https://doi.org/10.1016/s0039-6060(96)80223-6
  10. Tzakis AG, De Faria W, Angelis M, Verzaro R, Pinna A. Partial abdominal exenteration, ex vivo resection of a large mesenteric fibroma, and successful orthotopic intestinal autotransplantation. Surgery. 2000;128(3):486-489.  https://doi.org/10.1067/msy.2000.107165
  11. Sigel B, Bassett JG, Cooper DR, Dunn MR. Resection of the Superior Mesenteric Vein and Replacement with a Venous Autograft During Pancreaticoduodenectomy: Case Report. Annals of Surgery. 1965;162(5):941-945.  https://doi.org/10.1097/00000658-196511000-00021
  12. Fortner JG, Kim DK, Cubilla A, Turnbull A, Pahnke LD, Shils ME. Regional pancreatectomy: en bloc pancreatic, portal vein and lymph node resection. Annals of Surgery. 1977;186(1):42-50.  https://doi.org/10.1097/00000658-197707000-00007
  13. Amano H, Miura F, Toyota N, Wada K, Katoh K, Hayano K, Kadowaki S, Shibuya M, Maeno S, Eguchi T, Takada T, Asano T. Is pancreatectomy with arterial reconstruction a safe and useful procedure for locally advanced pancreatic cancer? Journal of Hepato-biliary-Pancreatic Surgery. 2009;16(6):850-857.  https://doi.org/10.1007/s00534-009-0190-7
  14. Wu G. Intestinal autotransplantation. Gastroenterology Reports. 2017;5(4):258-265.  https://doi.org/10.1093/gastro/gox027
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