Reviewer ’s report  
 
Title:  Feasibility of portal or superior mesenteric vein resection and reconstruction by allogeneic 
vein for pancreatic head cancer —a case -control study  
 
Version: 0 Date: 29 Jan 2018 
 
Reviewer:  Edoardo  Rosso  
 
Reviewer’s report:  
 
This in an interesting manuscript reporting a large experience of portal or superior mese nteric 
vein resection focusing on the value of allogenic vein for the reconstruction. The argument is of 
interest, in fact, thanks to modern chemotherapy, currently, we are able to offer a chance of 
surgical resection to many patients with initially non -resectable or borderline resectable tumors 
and most of these patients require vascular resections.  
 
 
The Authors should answer to the following  comments:  
 
Major comments  
 
* As quoted by the Authors and in line with the common experience of pancreatic surgeons 
expert in vascular resection, the need for an allogenic vein is limited for those patients in 
whom vein reconstruction is not feasible by other meaning (patch, direct, segmental, 
etc….), and constitute a sub -group of all patients requiring a venous resectio n. However, 
those patients, even if they are classified as T3 as patients not requiring venous graft, they 
have more advanced disease (more deep venous wall invasion, increase lymph nodes 
rartio, etc..). Therefore, we consider inappropriate to compare the oncologic outcome for 
patient requiring allogeneic vein (group A) or not (group B). Similarly, from the technical 
point of view allogenic vein replacement should be compared only with a similar 
technique (ex. artificial vascular graft, autologous vein….)  
 
 
Minor comments  
 
* Tables need revision: missing data (ex. in table 1 number for group A and B…)  
 
* English revision is text when adding your comments to the authors.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an addi tional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being pub lished  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the cont ent of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below . If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is  accepted for publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be included as confidential comments 
to the editors, which will n ot be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title:  Feasibility of portal or superior mesenteric vein resection and reconstruction by allogeneic 
vein for pancreatic head cancer —a case -control study  
 
Version: 0 Date: 29 Jan 2018 
 
Reviewer:  Edoardo  Rosso  
 
Reviewer’s report:  
 
This in an interesting manuscript reporting a large experience of portal or superior mese nteric 
vein resection focusing on the value of allogenic vein for the reconstruction. The argument is of 
interest, in fact, thanks to modern chemotherapy, currently, we are able to offer a chance of 
surgical resection to many patients with initially non -resectable or borderline resectable tumors 
and most of these patients require vascular resections.  
 
 
The Authors should answer to the following  comments:  
 
Major comments  
 
* As quoted by the Authors and in line with the common experience of pancreatic surgeons 
expert in vascular resection, the need for an allogenic vein is limited for those patients in 
whom vein reconstruction is not feasible by other meaning (patch, direct, segmental, 
etc….), and constitute a sub -group of all patients requiring a venous resectio n. However, 
those patients, even if they are classified as T3 as patients not requiring venous graft, they 
have more advanced disease (more deep venous wall invasion, increase lymph nodes 
rartio, etc..). Therefore, we consider inappropriate to compare the oncologic outcome for 
patient requiring allogeneic vein (group A) or not (group B). Similarly, from the technical 
point of view allogenic vein replacement should be compared only with a similar 
technique (ex. artificial vascular graft, autologous vein….)  
 
 
Minor comments  
 
* Tables need revision: missing data (ex. in table 1 number for group A and B…)  
 
* English revision is text when adding your comments to the authors.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an addi tional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being pub lished  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the cont ent of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below . If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is  accepted for publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be included as confidential comments 
to the editors, which will n ot be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title:  Feasibility of portal or superior mesenteric vein resection and reconstruction by allogeneic 
vein for pancreatic head cancer —a case -control study  
 
Version: 0 Date: 29 Jan 2018 
 
Reviewer:  Edoardo  Rosso  
 
Reviewer’s report:  
 
This in an interesting manuscript reporting a large experience of portal or superior mese nteric 
vein resection focusing on the value of allogenic vein for the reconstruction. The argument is of 
interest, in fact, thanks to modern chemotherapy, currently, we are able to offer a chance of 
surgical resection to many patients with initially non -resectable or borderline resectable tumors 
and most of these patients require vascular resections.  
 
 
The Authors should answer to the following  comments:  
 
Major comments  
 
* As quoted by the Authors and in line with the common experience of pancreatic surgeons 
expert in vascular resection, the need for an allogenic vein is limited for those patients in 
whom vein reconstruction is not feasible by other meaning (patch, direct, segmental, 
etc….), and constitute a sub -group of all patients requiring a venous resectio n. However, 
those patients, even if they are classified as T3 as patients not requiring venous graft, they 
have more advanced disease (more deep venous wall invasion, increase lymph nodes 
rartio, etc..). Therefore, we consider inappropriate to compare the oncologic outcome for 
patient requiring allogeneic vein (group A) or not (group B). Similarly, from the technical 
point of view allogenic vein replacement should be compared only with a similar 
technique (ex. artificial vascular graft, autologous vein….)  
 
 
Minor comments  
 
* Tables need revision: missing data (ex. in table 1 number for group A and B…)  
 
* English revision is text when adding your comments to the authors.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an addi tional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being pub lished  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the cont ent of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below . If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is  accepted for publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be included as confidential comments 
to the editors, which will n ot be published.  
 
I agree to the open peer review policy of the journal  
assistant