胰腺癌术后局部复发再次行手术切除的临床疗效分析  

Clinical Efficacy Analysis of Resurgical Resection in Patieats with Postoperative Local Recurrence of Pancreatic Cancer

作　　者：燎原 刘玉曼 朱世超 LIAO Yuan;LIU Yuman;ZHU Shichao(Henan People's Hospital,Zhengzhou University People's Hospital,Zhengzhou,450000)

机构地区：[1]河南省人民医院,郑州大学人民医院,450000 [2]郑州大学第一附属医院,450000

出　　处：《实用癌症杂志》2023年第8期1317-1320,共4页The Practical Journal of Cancer

摘　　要：目的 探讨再次手术切除治疗胰腺癌(PC)术后局部复发的疗效。方法 回顾性分析25例PC术后局部复发再次进行手术切除患者的病历资料,并纳为研究组,另选择相同时期PC手术过后局部复发且复发时间超过9个月未实施手术切除的25例患者为对照组。分析研究组手术时间、术中出血量、术中输血率、住院时间、并发症及术后病理学检查结果,并随访至2022年3月,对比两组患者总体生存时间和复发后生存时间。结果 研究组手术时间(158.56±23.41)min,术中出血量(126.34±31.58)ml,术中输血率为4.00%(1/25),术后住院时间(13.47±2.68)d;研究组再次术后总体并发症发生率为20.00%(5/25),其中术后出血1例,术后胃排空障碍2例,术后胰瘘2例;再次术后病理学检查结果显示:T分期,T1期3例、T2期7例、T3期5例、T4期10例;N分期,N0期21例、N1期4例、N2期0例;肿瘤分化程度,高分化6例、中分化12例、低分化7例;研究组患者首次术后中位总体生存时间为54.6个月,复发后中位生存时间为22.8个月,截至2022年3月末次随访,共6例死亡,19例存活,存活率为76.00%;对照组首次术后总体生存时间为22.3个月,复发后中位生存时间为10.7个月,截至2022年3月末次随访,共21例死亡,4例存活,存活率为16.00%;截至2022年3月末次随访,研究组患者存活率高于对照组,有统计学差异(P<0.05)。结论 针对PC术后局部复发患者再行手术切除治疗可延长患者生存时间,且创伤较轻,患者术中出血量偏少,术中输血率较低,并发症发生风险较低,对患者术后住院时间影响较小,临床可进行大力推行。Objective To investigate the efficacy of resurgical resection in patients with local recurrence after pancreatic cancer(PC)surgery.Methods The medical records of 25 patients with local reoperation resection after PC were analyzed retrospectively,and were included as the study group.25 patients with local recurrence after PC surgery in the same period for more than 9 months were selected as the control group.Operation time,intraoperative blood loss,intraoperative blood transfusion rate,hospital stay,complications and postoperative pathology examination results were analyzed in the study group,and follow-up until March 2022 to compare the overall survival time and post-recurrence survival time of the 2 groups.Results Operation time of the study group was(158.56±23.41) min,Intraoperative blood loss(126.34±31.58) ml,Intraoperative blood transfusion rate was 4.00%(1/25),The hospital stay was(13.47±2.68) d;The overall complication rate after repeat surgery in the study group was 20.00%(5/25),Among them,one case had postoperative bleeding,Postoperative gastric emptying disorder in 2 cases,2 cases of postoperative pancreatic fistula;The results of the second postoperative pathology examination showed that:T stage,3 in T1,7 in T2,5 in T3 and 10 in T4;N by stages,21 in N0,4 in N1 and 0 in N2;The degree of tumor differentiation,6 cases with high differentiation,12 cases with moderate differentiation and 7 cases with low differentiation;The median overall survival time after the first surgery in the study group was 54.6 months,The median survival time after relapse was 22.8 months,At the end of March 2022,A total of 6 deaths have occurred,The 19 patients were alive,The survival rate was 76.00%;The overall survival time after the first surgery in the control group was 22.3 months,The median survival time after recurrence was 10.7 months,At the end of March 2022,A total of 21 deaths have occurred,4 patients survived,The survival rate was 16.00%;At the end of March 2022,there was Higher survival rate in the study group than

关 键 词：胰腺癌 局部复发 再手术切除 病理学检查 并发症 生存时间 

分 类 号：R735.9[医药卫生—肿瘤]