Education and Professional Standing
FRCPC, Anatomical Pathology (2009)
Residency: Memorial University of Newfoundland (2009)
MD, Lviv State Medical University, Lviv, Ukraine.
PhD, Moscow, High Educational Commission, Russia
Assistant Clinical Professor, McMaster University
Staff Pathologist, Grand River Hospital and St Mary’s General Hospital, Regional HPB Centre, Kitchener
Given the key anatomical relationships of the pancreas to the superior mesenteric artery (SMA) and superior mesenteric vein (SMV), and the bearing this has on surgical management over the last decade, we have been developed innovative approach to handling and assessment of the pancreaticoduodenectomy (Whipple) (PD) specimens, with emphasize on the margins status, as well as, we have been proponents of rigorous and thorough sampling of the SMA and SMV (groove) margins. Extensive sampling of margins/surfaces in PD specimens has revealed that invasion of the peripancreatic fat by single malignant glands without significant desmoplastic reaction is relatively common and may not be identified on gross examination (unless extensively sampled), or with imaging. This is important for quality assurance, including feedback to the radiologists and surgeons who make preoperative and intraoperative decisions as to the separation of vessels from the pancreatic head, especially in borderline resectable cases.
Our proposal (clarification of terminology for the SMA margin, and inclusion of reporting of the SMV/portal vein/vascular groove surface/margin, as well as reporting the relationship of tumour to the anterior surface) are included in the new version of the CAP cancer reporting protocol.
Dr Maksymov is involved in the Undergraduate Medical Program and Post-Graduate Residency Training Program at the Grand River Hospital (Waterloo campus of McMaster University).