根治性顺行模块化胰脾切除术治疗胰体尾癌的手术安全性研究

Surgical outcomes of radical antegrade modular pancreatosplenectomy for pancreatic body and tail cancer

目的探讨根治性顺行模块化胰脾切除术(radical antegrade modular pancreatosplenectomy,RAMPS)临床上治疗胰体尾癌的安全性。方法回顾性收集接受RAMPS手术治疗的胰体尾部恶性肿瘤患者的相关临床资料,统计手术相关数据和术后并发症情况。结果研究共纳入330例接受RAMPS手术的胰体尾部导管腺癌患者,包括男性204例(61.8%)和女性126例(38.2%),年龄(62.4±9.2)岁;RAMPS手术时间为(130.6±44.3)min,53例患者联合>1个的器官切除(不包括左肾上腺),42例联合>1个的大血管切除,130例联合左肾上腺切除,清扫淋巴结数目为(17.8±3.2)枚,R0切除率为91.5%;术后总体并发症发生率为30.0%,主要为B级或C级胰瘘[17.3%(57/330)],2例发生围术期死亡。结论RAMPS手术在临床上是安全可行的,可提高胰体尾癌淋巴结清扫数量和R0切除率。

Objective To investigate the safety of radical antegrade modular pancreatosplenectomy(RAMPS)in the treatment of pancreatic body and tail cancer.Methods The clinical data of patients with pancreatic body and tail cancer treated with RAMPS were retrospectively collected.Surgical outcomes and postoperative complications were analyzed.Results A total of 330 patients with pancreatic body and tail cancer who underwent RAMPS surgery were included,containing 204 males(61.8%)and 126 females(38.2%),aged(62.4±9.2)years.The average operation time of RAMPS was(130.6±44.3)min.Fifty-three patients underwent surgery combined with more than one organ resection(excluding left adrenal gland),forty-two patients underwent surgery combined with more than one large vessel resection,and 130 patients combined with left adrenalectomy.The average number of harvested lymph nodes was(17.8±3.2).The R0 resection rate was 91.5%with the overall postoperative complication rate being 30.0%.The main complications were grade B or C pancreatic fistula[17.3%(57/330)],and 2 patients died during perioperative period.Conclusion RAMPS surgery is clinically safe and feasible,which can improve the number of lymph node dissection and R0 resection rate for pancreatic body and tail cancer.