CAJ | 학술논문

目的探讨意外胆囊(IGBC)治疗预后的危险因素及评价腹腔镜胆囊切除术(LC)对IGBC治疗预后的影响.方法回顾性分析2001年1月至2008年12月期间55例IGBC腺癌患者的临床资料.按不同手术方式将其分成3组,即腹腔镜组(n=23)、转开腹组(n=6)和开腹组(n=26).运用生存分析及Cox回归模型比较组间生存率差异及了解IGBC预后的相关危险因素.结果全组术后1、3、5年生存率分别为74.3%、47.7%、35.8%,中位生存期为36个月.各组生存率的差异无统计学意义(P＞0.05).Cox回归分析结果显示,病理T分期是影响IGBC预后的独立危险因素(OR=2.75,P=0.00);随着肿瘤浸润深度的增加,患者的牛存预后明显变差.而手术方式、切口种植等因素与预后无关(P＞0.05).结论 IGBC预后与病理T分期有关,而LC对IGBC的治疗预后与开腹胆囊切除术相比无差异.
목적 탐토의외담낭(IGBC)치료예후적위험인소급평개복강경담낭절제술(LC)대IGBC치료예후적영향.방법 회고성분석2001년1월지2008년12월기간55례IGBC선암환자적림상자료.안불동수술방식장기분성3조,즉복강경조(n=23)、전개복조(n=6)화개복조(n=26).운용생존분석급Cox회귀모형비교조간생존솔차이급료해IGBC예후적상관위험인소.결과 전조술후1、3、5년생존솔분별위74.3%、47.7%、35.8%,중위생존기위36개월.각조생존솔적차이무통계학의의(P＞0.05).Cox회귀분석결과현시,병리T분기시영향IGBC예후적독립위험인소(OR=2.75,P=0.00);수착종류침윤심도적증가,환자적우존예후명현변차.이수술방식、절구충식등인소여예후무관(P＞0.05).결론 IGBC예후여병리T분기유관,이LC대IGBC적치료예후여개복담낭절제술상비무차이.
Objective To investigate the prognostic risk factors in incidental gallbladder cancer (IGBC) and evaluate the effect of laparoscopic cholecystectomy(LC) applied in treating IGBC. Methods The retrospective study enrolled 55 patients with incidental gallbladder adenocarcinoma treated between January 2001 and December 2008. The patients were divided into three groups according to different surgical approaches; laparoscope group (n = 23), conversion group (n = 6 ) and laparotomy group (n = 26). Survival analysis and Cox regression model were applied to comparing the difference of survival rate between three groups and to analyzing the related prognostic risk factors of ICBC. Results The overall 1-,3- and 5-year survival rates were 74. 3% , 47. 7% and 35. 8% respectively. And the median survival time was 36 months. The outcome of survival rate between three groups was not different statistically. Cox regression analysis indicated that pathologic T stage was an independent risk factor influencing IGBC( OR = 2. 75, P =0. 00). The prognosis was getting worse according to the rising depth of tumor invasion. However, the other factors, such as surgical approach, tumor incisional implantation, ect. were not related to the prognosis ( P ＞0. 05). Conclusion The factor of pathologic T stage is related to the prognosis of IGBC for which LC,compared with open cholecystectomy, should not be regarded as a negative factor in treatment.