{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T21:57:23Z","timestamp":1784239043968,"version":"3.55.0"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,3,11]],"date-time":"2020-03-11T00:00:00Z","timestamp":1583884800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The aim of the present study was to investigate the feasibility of resection based on the nerve and fibrous tissue (NFT) structures around the superior mesenteric artery (SMA) for resectable pancreatic adenocarcinoma (R\u2010PDAC) patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>NFTs around the SMA were classified into four \u201c<jats:italic>intensive NTFs area\u201d<\/jats:italic> with spreading the NFTs around the SMA and three SMA nerve plexus regions without branching nerves according to autopsy findings. Complete dissection of four \u201c<jats:italic>intensive NTFs areas\u201d<\/jats:italic> was performed by pre\u2010exposing three SMA nerve plexus regions without branching nerves as \u201c<jats:italic>dissection\u2010guiding points\u201d<\/jats:italic> with SMA nerve plexus preservation (NFT\u2010based resection). Among 157 R\u2010PDAC patients undergoing pancreaticoduodenectomy, surgical outcomes of 78 patients with NFT\u2010based resection were compared with 59 patients with half\u2010SMA nerve plexus dissection and 20 patients without NFTs dissection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the NFT\u2010based resection group, 76.5% had tumor involvement and metastasis in each <jats:italic>intensive NTFs area<\/jats:italic>. Operative time, blood loss, and postoperative diarrhea rate were significantly lower in NFT\u2010based resection than in half\u2010SMA nerve plexus group (321 vs 390\u00a0min; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.01, 228 vs 550\u00a0mL; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.01, 5.1% vs 15.3%; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.04, respectively). R0 rate and median overall survival significantly improved in NFT\u2010based resection than in non\u2010NFT dissection group (93.6% vs 65.0%; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.01, 49.6 vs 23.6\u00a0months, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>NFT\u2010based resection may become a novel method for R\u2010PDAC patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhbp.725","type":"journal-article","created":{"date-parts":[[2020,2,12]],"date-time":"2020-02-12T03:01:40Z","timestamp":1581476500000},"page":"342-351","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":48,"title":["Precise anatomical resection based on structures of nerve and fibrous tissue around the superior mesenteric artery for mesopancreas dissection in pancreaticoduodenectomy for pancreatic cancer"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1169-8160","authenticated-orcid":false,"given":"Yuichi","family":"Nagakawa","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal and Pediatric Surgery Tokyo Medical University Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuang\u2010Qin","family":"Yi","sequence":"additional","affiliation":[{"name":"Department of Frontier Health Sciences Graduate School of Human Health Sciences Tokyo Metropolitan University Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chie","family":"Takishita","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal and Pediatric Surgery Tokyo Medical University Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yatsuka","family":"Sahara","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal and Pediatric Surgery Tokyo 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Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iwao","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Anatomy School of Life Dentistry at Tokyo The Nippon Dental University Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiko","family":"Tsuchida","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal and Pediatric Surgery Tokyo Medical University Tokyo 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