Resection of the mesopancreas (RMP): a new surgical classification of a known anatomical space

<p>Abstract</p> <p>Background</p> <p>Prognosis after surgical therapy for pancreatic cancer is poor and has been attributed to early lymph node involvement as well as to a strong tendency of cancer cells to infiltrate into the retropancreatic tissue and to spread along...

Full description

Bibliographic Details
Main Authors: Konerding Moritz A, Wolloscheck Tanja, Domeyer Mario, Gockel Ines, Junginger Theodor
Format: Article
Language:English
Published: BMC 2007-04-01
Series:World Journal of Surgical Oncology
Online Access:http://www.wjso.com/content/5/1/44
_version_ 1829106866167218176
author Konerding Moritz A
Wolloscheck Tanja
Domeyer Mario
Gockel Ines
Junginger Theodor
author_facet Konerding Moritz A
Wolloscheck Tanja
Domeyer Mario
Gockel Ines
Junginger Theodor
author_sort Konerding Moritz A
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Prognosis after surgical therapy for pancreatic cancer is poor and has been attributed to early lymph node involvement as well as to a strong tendency of cancer cells to infiltrate into the retropancreatic tissue and to spread along the peripancreatic neural plexuses. The objective of our study was to classify the anatomical-surgical layer of the mesopancreas and to describe the surgical principles relevant for resection of the mesopancreas (RMP). Immunohistochemical investigation of the mesopancreatic-perineural lymphogenic structures was carried out with the purpose of identifying possible routes of metastatic spread.</p> <p>Methods</p> <p>Resection of the mesopancreas (RMP) was performed in fresh corpses. Pancreas and mesopancreas were separated from each other and the mesopancreas was immunohistochemically investigated.</p> <p>Results</p> <p>The mesopancreas strains itself dorsally of the mesenteric vessels as a whitish-firm, fatty tissue-like layer. Macroscopically, in the dissected <it>en-bloc </it>specimens of pancreas and mesopancreas nerve plexuses were found running from the dorsal site of the pancreatic head to the mesopancreas to establish a perineural plane. Immunohistochemical examinations revealed the lymphatic vessels localized in direct vicinity of the neuronal plexuses between pancreas and mesopancreas.</p> <p>Conclusion</p> <p>The mesopancreas as a perineural lymphatic layer located dorsally to the pancreas and reaching beyond the mesenteric vessels has not been classified in the anatomical or surgical literature before. The aim to ensure the greatest possible distance from the retropancreatic lymphatic tissue which drains the carcinomatous focus can be achieved in patients with pancreatic cancer only by complete resection of the mesopancreas (RMP).</p>
first_indexed 2024-12-12T06:29:37Z
format Article
id doaj.art-125f9d924b9a496e96f68712287a5fdf
institution Directory Open Access Journal
issn 1477-7819
language English
last_indexed 2024-12-12T06:29:37Z
publishDate 2007-04-01
publisher BMC
record_format Article
series World Journal of Surgical Oncology
spelling doaj.art-125f9d924b9a496e96f68712287a5fdf2022-12-22T00:34:38ZengBMCWorld Journal of Surgical Oncology1477-78192007-04-01514410.1186/1477-7819-5-44Resection of the mesopancreas (RMP): a new surgical classification of a known anatomical spaceKonerding Moritz AWolloscheck TanjaDomeyer MarioGockel InesJunginger Theodor<p>Abstract</p> <p>Background</p> <p>Prognosis after surgical therapy for pancreatic cancer is poor and has been attributed to early lymph node involvement as well as to a strong tendency of cancer cells to infiltrate into the retropancreatic tissue and to spread along the peripancreatic neural plexuses. The objective of our study was to classify the anatomical-surgical layer of the mesopancreas and to describe the surgical principles relevant for resection of the mesopancreas (RMP). Immunohistochemical investigation of the mesopancreatic-perineural lymphogenic structures was carried out with the purpose of identifying possible routes of metastatic spread.</p> <p>Methods</p> <p>Resection of the mesopancreas (RMP) was performed in fresh corpses. Pancreas and mesopancreas were separated from each other and the mesopancreas was immunohistochemically investigated.</p> <p>Results</p> <p>The mesopancreas strains itself dorsally of the mesenteric vessels as a whitish-firm, fatty tissue-like layer. Macroscopically, in the dissected <it>en-bloc </it>specimens of pancreas and mesopancreas nerve plexuses were found running from the dorsal site of the pancreatic head to the mesopancreas to establish a perineural plane. Immunohistochemical examinations revealed the lymphatic vessels localized in direct vicinity of the neuronal plexuses between pancreas and mesopancreas.</p> <p>Conclusion</p> <p>The mesopancreas as a perineural lymphatic layer located dorsally to the pancreas and reaching beyond the mesenteric vessels has not been classified in the anatomical or surgical literature before. The aim to ensure the greatest possible distance from the retropancreatic lymphatic tissue which drains the carcinomatous focus can be achieved in patients with pancreatic cancer only by complete resection of the mesopancreas (RMP).</p>http://www.wjso.com/content/5/1/44
spellingShingle Konerding Moritz A
Wolloscheck Tanja
Domeyer Mario
Gockel Ines
Junginger Theodor
Resection of the mesopancreas (RMP): a new surgical classification of a known anatomical space
World Journal of Surgical Oncology
title Resection of the mesopancreas (RMP): a new surgical classification of a known anatomical space
title_full Resection of the mesopancreas (RMP): a new surgical classification of a known anatomical space
title_fullStr Resection of the mesopancreas (RMP): a new surgical classification of a known anatomical space
title_full_unstemmed Resection of the mesopancreas (RMP): a new surgical classification of a known anatomical space
title_short Resection of the mesopancreas (RMP): a new surgical classification of a known anatomical space
title_sort resection of the mesopancreas rmp a new surgical classification of a known anatomical space
url http://www.wjso.com/content/5/1/44
work_keys_str_mv AT konerdingmoritza resectionofthemesopancreasrmpanewsurgicalclassificationofaknownanatomicalspace
AT wolloschecktanja resectionofthemesopancreasrmpanewsurgicalclassificationofaknownanatomicalspace
AT domeyermario resectionofthemesopancreasrmpanewsurgicalclassificationofaknownanatomicalspace
AT gockelines resectionofthemesopancreasrmpanewsurgicalclassificationofaknownanatomicalspace
AT jungingertheodor resectionofthemesopancreasrmpanewsurgicalclassificationofaknownanatomicalspace