胰体尾癌标准或扩大胰体尾切除术近远期疗效比较

Comparison of Short-term and Long-term Curative Effects Between Standard and Extended Distal Pancreatectomy in Treatment of Pancreatic Body and Tail Carcinoma

目的比较分析标准与扩大胰体尾切除术治疗胰体尾癌的近远期疗效,并探讨影响预后相关因素。方法对2015年1月至2017年8月择期行手术治疗的80例胰体尾癌患者相关资料回顾性分析,依据不同术式将其分为A组(标准胰体尾切除术)与B组(扩大胰体尾切除术),比较两组近远期疗效,并通过Cox回归分析影响预后相关因素。结果A组平均手术时间、术中出血量、肿瘤最大径均显著少于B组(P<0.05);A组输血率(16.33%)显著低于B组的(48.39%,P<0.05);A组并发症总发生率与B组比较无显著差异(P>0.05);两组T分期比较差异有统计学意义(P<0.05);A组1年生存率(61.22%)显著高于B组的(29.03%,P<0.05),但两组3年生存率比较无显著差异(P>0.05);Cox回归模型分析显示肿瘤大小是影响胰体尾癌切除术后预后的独立危险因素(P<0.05)。结论相比标准胰体尾切除术,扩大胰体尾切除术手术时间明显长,术中出血量明显多,输血率明显高,但两者术后并发症发生率、3年生存率类似,临床可行。此外,胰体尾癌预后疗效受肿瘤大小影响。

Objective To comparatively analyze the short-term and long-term curative effects of standard and extended distal pancreatectomy in treatment of pancreatic body and tail carcinoma,and explore the prognostic factors.Methods Relevant data of 80 patients with pancreatic body and tail carcinoma who underwent elective surgery between January 2015 and August 2017 were analyzed retrospectively.According to the surgical method,the patients were divided into group A(standard distal pancreatectomy)and group B(extended distal pancreatectomy).Short-term and long-term curative effects were comparatively analyzed,and Cox regression analysis of prognostic factors was performed.Results The mean operation time,intraoperative blood loss and the maximum tumor diameter of group A were significantly shorter/less/smaller than those of group B(P<0.05).Theblood transfusion rate of group A(16.33%)was significantly lower than that of group B(48.39%)(P<0.05).There was no significant difference in the total incidence of complications between the 2 groups(P>0.05),but there were significant differences in T staging between the 2 groups(P<0.05).The 1-year survival rate of group A(61.22%)was significantly higher than that of group(29.03%)(P<0.05),but there was no significant difference in 3-year survival rate between the 2 groups(P>0.05).Cox regression analysis showed that tumor size was an independent risk factor of prognosis after distal pancreatectomy.Conclusion Compared with standard distal pancreatectomy,the duration of extended distal pancreatectomy is significantly longer,intraoperative blood loss is more,and blood transfusion rate is higher.However,the two were similar in terms of the incidence of postoperative complications and 3-year survival rate.Additionally,the prognosis of patients with pancreatic body and tail carcinoma is affected by tumor size.