腹腔镜下根治性顺行模块化胰脾切除术与脻体尾切除术治疗胰体尾癌的效果分析  

Analysis on efficacy of laparoscopic radical anterograde modular pancreaticosplenectomy and distal pancreaticosplenectomy in treatment of pancreatic body and tail cancer

作　　者：王涛[1] 常莹 王钢[1] 李永利[1] 雷达[1] WANG Tao;CHANG Ying;WANG Gang;LI Yongli;LEI Da(Second Department of Hepatobiliary Pancreatic and Splenic Surgery,Baoji Municipal Central Hospital,Baoji,Shaanxi 721008,China)

机构地区：[1]陕西省宝鸡市中心医院肝胆胰脾外科二科,陕西宝鸡721008

出　　处：《检验医学与临床》2024年第1期118-122,共5页Laboratory Medicine and Clinic

摘　　要：目的 分析腹腔镜下根治性顺行模块化胰脾切除术(LRAMPS)与脻体尾切除术(DPS)治疗胰体尾癌的效果。方法 选择该院2018年6月至2022年6月肝胆胰脾外科收治的86例胰体尾癌患者临床资料,根据患者所选术式不同分为LRAMPS组(40例)和DPS组(46例),比较两组手术情况、术后预后情况等。对两组随访至2022年12月,分析两组生存情况。结果 两组患者均顺利完成手术,住院期间无死亡病例。LRAMPS组术中出血量少于DPS组(P<0.05),术后24 h视觉模拟评分法(VAS)评分低于DPS组(P<0.05),R0切除率高于DPS组(P<0.05)。两组总有效率比较,差异无统计学意义(P>0.05)。对两组随访6~54个月,LRAMPS组复发率及肝转移率显著低于DPS组(P<0.05)。LRAMPS组术后中位生存期为18.5个月,DPS组为12.2个月,差异有统计学意义(P<0.05)。LRAMPS组术后18、24、36、48、54个月的存活率显著高于DPS组(P<0.05)。结论 DPS与LRAMPS治疗胰体尾癌的近期预后情况并无明显差异,但LRAMPS可减少患者术中出血量,减轻患者术后疼痛。在长期预后方面,LRAMPS较DPS治疗效果更佳,能有效延长患者生存期间,提高患者存活率,改善患者预后。Objective To analyze the efficacy of laparoscopic radical anterograde modular pancreaticosplenectomy(LRAMPS)and distal pancreaticosplenectomy(DPS)in the treatment of pancreatic body and tail cancer.Methods The clinical data in 68 cases of pancreatic body and tail cancer treated in this hospital from June 2018 to June 2022 were selected.The patients were divided into the LRAMPS group(40 cases)and the DPS group(46 cases)according to the different surgical methods chosen by the patients.The surgical situation and postoperative prognosis etc.were compared between the two groups.Two groups were followed up until December 2022.The survival situation in the two groups was analyzed.Results The both groups successfully completed the surgery without the death during hospitalization.The intraoperative bleeding volume of the LRAMPS group was lower than that of the DPS group(P<0.05),the visual analogue scale(VAS)scores at postoperative 24 h in the LRAMPS group was lower than that in the DPS group(P<0.05),and the R0 incision rate in the LRAMPS group was higher than that in the DPS group(P<0.05).There was no statistically significant difference in the total treatment effect rate between the two groups(P>0.05).The two groups were followed up for 6-54 months,the recurrence rate and liver metastasis rate in the LRAMPS group were significantly lower than those in the DPS group(P<0.05).The postoperative median survival time in the LRAMPS group was 18.5 months and 12.2 months in the DPS group,and the difference was statistically significant(P<0.05).The survival rates in postoperative 18,24,36,48,54 months in the LRAMPS group were significantly higher than those in the DPS group(P<0.05).Conclusion There are no significant difference in the short-term prognosis between the DPS surgery and LRAMPS group for treating pancreatic body and tail cancer,but LRAMPS could reduce the intraoperative bleeding volume and postoperative pain of the patients.In terms of longer prognosis,LRAMPS has a better therapeutic effect than DPS,which could effect

关 键 词：腹腔镜 根治性顺行模块化胰脾切除术 脻体尾切除术 胰体尾癌 疗效 

分 类 号：R657.51[医药卫生—外科学]