中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2010年
9期
972-974
,共3页
徐强%苏刚%李宝定%吴江河
徐彊%囌剛%李寶定%吳江河
서강%소강%리보정%오강하
腹腔镜胆囊切除术%根治性胆囊切除术%胆囊癌
腹腔鏡膽囊切除術%根治性膽囊切除術%膽囊癌
복강경담낭절제술%근치성담낭절제술%담낭암
Laparoscopic cholecystectomy%Radical cholecystectomy%Gallbladder carcinoma
目的 通过对比研究,评价腹腔镜胆囊切除术(LC)与根治性胆囊切除术(RC)两种方法治疗早期胆囊癌的临床疗效.方法 采用回顾性研究,选择2001年1月至2008年12月在我院确诊并行手术治疗的63例早期胆囊癌患者,按其所接受的治疗方法分为LC组(28例)与RC组(35例).对2组患者术后的并发症发生率、生存率及复发率等方面进行比较.结果 LC组患者术后并发症发生率为7.1%(2/28),与RC组的48.6%(17/35)发生率相比,差异有统计学意义(χ2=12.675,P＜0.01).RC组中Ⅰ期患者的术后第1、3、5年累积生存率均为100%,Ⅱ期为76.2%、42.9%和23.8%;LC组Ⅰ期为81. 8%、54.5%和27.3%,Ⅱ期为17.6%、5.9%、0.0%.两组同期生存曲线经log-rank检验,差异均有统计学意义(Ⅰ期:χ2=20.74,P＜0.01;Ⅱ期:χ2=11.35,P＜0.01),RC组的生存率优于LC组.RC组术后1、3、5年肿瘤累积复发率分别为20.0%、48.6%、68.6%,LC组为60.7%、85.7%、92.9%,两组比较,差异有统计学意义(χ2=10.30,P=0.0013),RC组术后的复发率显著低于LC组.结论 对于早期胆囊癌患者,首选的外科治疗方法是根治性胆囊切除术,这对降低术后肿瘤复发率,提高远期生存质量有重要作用.
目的 通過對比研究,評價腹腔鏡膽囊切除術(LC)與根治性膽囊切除術(RC)兩種方法治療早期膽囊癌的臨床療效.方法 採用迴顧性研究,選擇2001年1月至2008年12月在我院確診併行手術治療的63例早期膽囊癌患者,按其所接受的治療方法分為LC組(28例)與RC組(35例).對2組患者術後的併髮癥髮生率、生存率及複髮率等方麵進行比較.結果 LC組患者術後併髮癥髮生率為7.1%(2/28),與RC組的48.6%(17/35)髮生率相比,差異有統計學意義(χ2=12.675,P＜0.01).RC組中Ⅰ期患者的術後第1、3、5年纍積生存率均為100%,Ⅱ期為76.2%、42.9%和23.8%;LC組Ⅰ期為81. 8%、54.5%和27.3%,Ⅱ期為17.6%、5.9%、0.0%.兩組同期生存麯線經log-rank檢驗,差異均有統計學意義(Ⅰ期:χ2=20.74,P＜0.01;Ⅱ期:χ2=11.35,P＜0.01),RC組的生存率優于LC組.RC組術後1、3、5年腫瘤纍積複髮率分彆為20.0%、48.6%、68.6%,LC組為60.7%、85.7%、92.9%,兩組比較,差異有統計學意義(χ2=10.30,P=0.0013),RC組術後的複髮率顯著低于LC組.結論 對于早期膽囊癌患者,首選的外科治療方法是根治性膽囊切除術,這對降低術後腫瘤複髮率,提高遠期生存質量有重要作用.
목적 통과대비연구,평개복강경담낭절제술(LC)여근치성담낭절제술(RC)량충방법치료조기담낭암적림상료효.방법 채용회고성연구,선택2001년1월지2008년12월재아원학진병행수술치료적63례조기담낭암환자,안기소접수적치료방법분위LC조(28례)여RC조(35례).대2조환자술후적병발증발생솔、생존솔급복발솔등방면진행비교.결과 LC조환자술후병발증발생솔위7.1%(2/28),여RC조적48.6%(17/35)발생솔상비,차이유통계학의의(χ2=12.675,P＜0.01).RC조중Ⅰ기환자적술후제1、3、5년루적생존솔균위100%,Ⅱ기위76.2%、42.9%화23.8%;LC조Ⅰ기위81. 8%、54.5%화27.3%,Ⅱ기위17.6%、5.9%、0.0%.량조동기생존곡선경log-rank검험,차이균유통계학의의(Ⅰ기:χ2=20.74,P＜0.01;Ⅱ기:χ2=11.35,P＜0.01),RC조적생존솔우우LC조.RC조술후1、3、5년종류루적복발솔분별위20.0%、48.6%、68.6%,LC조위60.7%、85.7%、92.9%,량조비교,차이유통계학의의(χ2=10.30,P=0.0013),RC조술후적복발솔현저저우LC조.결론 대우조기담낭암환자,수선적외과치료방법시근치성담낭절제술,저대강저술후종류복발솔,제고원기생존질량유중요작용.
Objective To compare the efficiency of laparoscopic cholecystectomy (LC) and radical cholecystectomy (RC) in the patients with early gallbladder carcinoma. Methods From January 2001 to December 2008, 63 patients who had underwent LC(28 cases) or RC(35 cases) were analyzed retrospectively. The survival and recurrence rate after operation and complication were compared. Results After treatment, the complication in the LC group was less than that in the RC group (7. 1% vs. 48. 6%, χ2 = 12. 675 ,P ＜0.01). In the RC group,the 1,3,5 year overall cumulative survival rate of Nevein phase Ⅰ were all 100%, and 76. 2%, 42. 9%, and 23. 8% respectively in the phase Ⅱ. The overall cumulative survival rate of LC cases were 81.8%, 54. 5%,27.3% in phase Ⅰ and 17.6% ,5.9% ,0.0% in phase Ⅱ, respectively. The survival curves between the two groups were significantly diffierent(phase Ⅰ χ2 =20.74,P＜0.001; phase Ⅱ χ2 = 11.35,P＜0.001) and the survival rate in the RC group was higher than that in the LC group. The 1,3,5 year cumulative recurrence rates in the RC were 20.0%, 48. 6%, 68. 6%, respectively, which is significantly lower than those in the LC group (60.7%,85.7% and92.9%, respectively)(χ2 =10.30,P=0.0013).Conclusions RC is one of the first choices for early gallbladder carcinoma treatment, and will decrease the recurrence rate and improve the long-term life quality.
