胰头导管腺癌静脉切除术的疗效分析。

Mark Hartel, Marco Niedergethmann, Michael Farag-Soliman, Jörg W Sturm, Axel Richter, Michael Trede, Stefan Post
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引用次数: 72

摘要

目的:探讨导管胰腺癌行胰十二指肠切除术时静脉切除是否有益。设计:回顾性研究。地点:德国曼海姆大学医院/海德堡。干预措施:1980年至2001年间,271例患者因胰头导管腺癌进行了手术切除。比较同时切除大静脉(门静脉和/或肠系膜上静脉)的患者(n = 68)和未同时切除大静脉的患者(n = 203)的结果。主要结局测量:5年生存率。结果:两组在分期、神经周围浸润、癌性淋巴管病、手术时间、出血量、输血等方面存在显著差异。然而,围手术期发病率(27%和22%)、死亡率(4%和3%)和长期生存率(5年23%和24%)没有差异。边缘无肿瘤(R0切除)患者的亚组分析显示,那些进行静脉切除且组织学检查未显示肿瘤浸润的患者具有最有利的结果。结论:没有理由排除疑似静脉浸润的患者行根治性胰十二指肠切除术,包括静脉切除术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Benefit of venous resection for ductal adenocarcinoma of the pancreatic head.

Objective: To find out whether there is any benefit from venous resection during pancreaticoduodenectomy for ductal pancreatic adenocarcinoma.

Design: Retrospective study.

Setting: University Hospital Mannheim/Heidelberg, Germany.

Interventions: 271 patients had resections for ductal adenocarcinoma of the pancreatic head between 1980 and 2001. The outcome of patients who did (n = 68) and who did not (n = 203) have simultaneous resection of major veins (portal vein and/or superior mesenteric vein) were compared.

Main outcome measurement: 5 year survival.

Results: The groups differed significantly regarding stage, perineural infiltration, lymphangiosis carcinomatosa, operating time, blood loss, and blood transfusion. However, there was no difference in perioperative morbidity (27% and 22%), mortality (4% and 3%), and long-term survival (at 5 years 23% and 24%). Subgroup analysis of patients with margins free of tumour (R0 resections) showed that those patients who had venous resections in whom histological examination did not show infiltration of tumour had the most favourable outcome.

Conclusion: There is no reason to exclude patients with suspected venous infiltration from radical pancreaticoduodenectomy including venous resection.

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