胰腺转移性肾细胞癌的手术治疗(附3例报告)  

Surgical treatment of pancreatic metastases from renal cell carcinoma:A report of 3 cases

作　　者：林贤超[1] 黄鹤光[1] 陈燕昌[1] 陆逢春[1] 林荣贵[1] 杨媛媛[1] LINXian-chao;HUANG He-guang;CHEN Yan-chang(Department of General Surgery,Fufian Medical University Union Hospital,Fuzhou 350001,China)

机构地区：[1]福建医科大学附属协和医院基本外科,福建福州350001

出　　处：《中国实用外科杂志》2018年第9期1068-1070,共3页Chinese Journal of Practical Surgery

基　　金：国家级临床重点专科建设项目及福建省临床重点专科建设项目[闽财指(2012)966号];福建省微创医学中心[闽卫医政函(2017)171号;闽政办(2017)4号]

摘　　要：目的探讨手术治疗胰腺转移性肾细胞癌(PMRCC)的价值。方法回顾性分析2010年10月至2018年4月福建医科大学附属协和医院3例手术PMRCC病人的临床资料,包括一般资料、临床表现、辅助检查、手术情况、术后随访情况等。结果 3例PMRCC,2例肿瘤为多发,1例肿瘤为单发。3例病人均无临床症状,原发肿瘤均为肾透明细胞癌,胰腺转移距肾癌手术时间间隔为3~15年,平均7年。2例行腹腔镜胰体尾+脾切除术,1例行全胰十二指肠切除术。3例均无胰瘘,2例术后并发腹腔感染。术后病理学检查结果均为胰腺转移性透明细胞癌。1例病人胰腺术后生存时间为22个月,另2例分别随访15个月及39个月仍无瘤生存。结论 PMRCC总体预后较好,手术治疗适用于孤立性PMRCC,尤其是胰体尾病例。Objective To investigate the value of surgery in the management of pancreatic metastases from renal cell carcinoma （PMRCC）.Methods The clinical data of 3 patients with PMRCC who underwent panereatectomy in Fujian Medical University Union Hospital between October 2010 and April 2018 were reviewed, including general information, accessary examination, perioperative data and follow-up status. Results Of the 3 patients, 2 patients had multiple lesions of the pancreas and the other one had a single lesion of pancreas. All of the 3 cases were asymptomatic. Primary cancer was renal clear cell cancer in all of them and the mean time from resection of the primary tumor to pancreatic metastases was 7 years （range 3-15 years）. Two patients underwent laparoscopic distal pancreatectomy with splenectomy and 1 underwent total pancreatectomy. Intra-abdominal infection was observed in 2 patients after pancreatic surgery and no pancreatic fistula occurred.Postoperative pathological diagnosis was metastatic renal cell carcinoma in all of the 3 patients. One patient died at 22 months after the pancreatic surgery and the other 2 patients were disease free with a follow-up of 15 and 39 months respectively. Conclusion The prognosis of PMRCC is good. Surgical treatment is suitable for isolated PMRCC, especially for the metastases in the body and tail of pancreas.

关 键 词：胰腺转移癌 肾细胞癌 

分 类 号：R6[医药卫生—外科学]