O. Kit, O. V. Katelnitskaya, A. Maslov, Yuriy A. Gevorkyan, E. Kolesnikov
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引用次数: 0
摘要
的目标。目的探讨胰腺癌静脉壁肿瘤浸润静脉切除术的效果。材料与方法。本研究纳入74例PC伴肿瘤侵袭肠系膜-门静脉系统壁(T3 N0-1 M0)的患者。对照组为53例接受姑息性化疗的患者。手术治疗组患者平均年龄为61.8±9.8岁,对照组患者平均年龄为63.2±10.1岁(p >0.05),肿瘤平均直径分别为39 mm和43 mm (p >0.05)。手术治疗组肿瘤位于胰头(P) 62例,行胰十二指肠联合静脉切除术。其余病例(n=12)肿瘤位于P体,对P行尾尾切除并静脉切除。结果。术后早期2.7%的患者发生重建区血栓形成,1.4%的患者发生出血。术后30天死亡率为4.1%。静脉切除手术治疗PC的中位生存期高于姑息性化疗:19个月vs 13个月,(0.05)。结论。与姑息性化疗相比,血管成形术可以在显微镜下完全切除肠系膜-门静脉系统浸润的PC患者的肿瘤,从而提高患者的生存率。
Venous resections and reconstructions in surgery of pancreatic cancer
Aim. To evaluate results of venous resections in tumor infiltration of venous wall in pancreatic cancer (PC). Materials and Methods. The study included 74 patients with PC and tumor invasion of the wall of the mesenteric-portal system (T3 N0-1 M0). The control group included patients (n=53), receiving palliative chemotherapy. The average age of patients in the group of surgical treatment was 61.8±9.8 years, in the control group – 63.2±10.1 years (р>0.05), the average diameter of the tumor was 39 mm and 43 mm, respectively (р>0.05). In 62 cases of the group of surgical treatment the tumor was located in the head of pancreas (P), the patients were conducted pancreaticoduodenal resection with venous resection. In the rest of cases (n=12) the tumor was located in the body of P, corporocaudal resection of P was conducted with venous resection. Results. In the early postoperative period 2.7% of patients developed thrombosis of the reconstruction zone, 1.4% developed bleeding. 30-Day postoperative lethality was 4.1%. Median survival in surgical treatment of PC with venous resection was higher in comparison with palliative chemotherapy: 19 months vs 13 months, р 0.05). Conclusions. Angioplastic interventions permitting to achieve microscopically complete resection of the tumor in PC with tumor infiltration of mesenteric-portal system, permit to improve survival of patients in comparison with palliative chemotherapy.