腹腔镜与开腹胰体尾切除术对胰腺导管腺癌的治疗经验（英文）

发布时间：2018-02-13 04:14

本文关键词： 腹腔镜胰体尾切除术开腹胰体尾切除术胰腺肿瘤胰漏　出处：《Journal of Zhejiang University-Science B(Biomedicine & Biotechnology)》2017年06期 　论文类型：期刊论文

【摘要】：目的:评估腹腔镜(LDP)与开腹胰体尾切除术(ODP)的并发症发生率和肿瘤清除效果。创新点:本组病例的腹腔镜手术组采用endo-GIA缓慢压榨方法处理胰腺残端,并采用根治性顺行模块化胰脾切除术,获得了较低的术后胰漏发生率和良好的手术清除效果。方法:收集4年间实施胰体尾切除手术的胰腺导管腺癌病例资料,进行回顾性分析。结论:22例胰腺导管腺癌进行了LDP手术,76例病人进行了ODP手术。比较LDP和ODP组,两组在胰漏(P=0.62)、腹腔内脓肿(P=0.44)和术后出血(P=0.34)发生率无显著性差异。LDP组和ODP组术中获取的淋巴结数量(11.2±4.6 vs.14.4±5.5,P=0.44)和淋巴结阳性病例数(36%vs.41%,P=0.71)无显著性差异。切缘阳性发生率(9%vs.13%,P=0.61)也无显著性差异。LDP组平均生存期(29.6±3.7)月,ODP组为(27.6±2.1)月,无显著性差异(P=0.35)。综上所述,腹腔镜胰体尾切除术对早期的胰腺导管癌是安全有效的。采用endo-GIA缓慢压榨方法可以预防术后胰漏发生,腹腔镜下根治性顺行模块化胰腺切除有利于肿瘤清除。腹腔镜手术可以达到和传统开腹手术相似的肿瘤清除效果。
[Abstract]:Objective: To evaluate laparoscopic (LDP) and open distal pancreatectomy (ODP) complication rate and tumor removal. Innovations: laparoscopic surgery group in the group of patients with endo-GIA slow squeezing method of pancreatic stump treatment, and the radical resection of the pancreas and spleen antegrade modular, incidence rate and good operation the scavenging effect of pancreatic leakage has low postoperative pancreatic ductal adenocarcinoma. Methods: clinical data collected during the past 4 years, the implementation of the body and tail of pancreas resection surgery, were retrospectively analyzed. Results: 22 cases of pancreatic ductal adenocarcinoma by LDP surgery, 76 patients underwent ODP surgery. Comparison between LDP and ODP group, two in the group of pancreatic leakage (P=0.62), intra-abdominal abscess (P=0.44) and postoperative hemorrhage (P=0.34) there was no significant difference between.LDP group and the acquisition of ODP group of intraoperative lymph node number (11.2 + 4.6 vs.14.4 + 5.5, P=0.44) and lymph node positive cases (36%vs.41%, P=0.71) had no significant difference The incidence of positive margin difference. (9%vs.13%, P=0.61) and there was no significant difference in.LDP group the average survival period (29.6 + 3.7), ODP group (27.6 + 2.1) months, no significant difference (P=0.35). In summary, laparoscopic distal pancreatectomy is safe and effective for pancreatic cancer early. Using endo-GIA slow squeezing method can occur in prevention of postoperative pancreatic leakage, laparoscopic radical resection for antegrade modular pancreatic tumor removal. Laparoscopic surgery and traditional open surgery can achieve similar tumor removal.

【作者单位】： Department
【基金】：supported by the Zhejiang Provincial Natural Science Foundation of China(No.LY17H160026)
【分类号】：R735.9

【相似文献】