CAJ | 학술논문

目的探讨提高累及肠系膜根部的胰头钩突癌手术切除的安全性和术后生存率的方法 .方法 2004年1月至2008年3月,第二军医大学附属长海疾院普外科采用全程游离肠系膜上动脉(SMA)的方法 ,连续为26例胰头钩突导管腺癌患者施行以肠系膜根部切除为重点的扩大胰十二指肠切除术.其中男性16例,女性10例,年龄30～75岁,中位年龄(55.0±13.0)岁.11例施行部分门静脉和肠系膜上静脉联合切除.对所有手术切除标本进行病理学检查,并对患者进行跟踪随访.结果全组无手术死亡.所有术后标本手术切缘均为阴性.患者接受7～45个月随访,26例患者的疼痛症状得到了完全缓解,1年和2年累积生存率分别为72.2%和48.1%.结论在扩大胰十二指肠切除术治疗胰头钩突癌中采用全程游离SMA的方法 ,可以在一定程度上提高手术安全性和彻底性,并有益于术后生存率和生活质量的提高.
목적 탐토제고루급장계막근부적이두구돌암수술절제적안전성화술후생존솔적방법 .방법 2004년1월지2008년3월,제이군의대학부속장해질원보외과채용전정유리장계막상동맥(SMA)적방법 ,련속위26례이두구돌도관선암환자시행이장계막근부절제위중점적확대이십이지장절제술.기중남성16례,녀성10례,년령30～75세,중위년령(55.0±13.0)세.11례시행부분문정맥화장계막상정맥연합절제.대소유수술절제표본진행병이학검사,병대환자진행근종수방.결과 전조무수술사망.소유술후표본수술절연균위음성.환자접수7～45개월수방,26례환자적동통증상득도료완전완해,1년화2년루적생존솔분별위72.2%화48.1%.결론 재확대이십이지장절제술치료이두구돌암중채용전정유리SMA적방법 ,가이재일정정도상제고수술안전성화철저성,병유익우술후생존솔화생활질량적제고.
Objective To impmve the prognosis and safety of extended panereaticoduodenectomy for patients with pancreatic cancer in the uncinate process of pancreas.Methods From January 2004 to March 2008,26 extended pancreaticoduodenectomies with full length superior mesenteric artery(SMA) isolation and mesentery root resection were performed for the ductal adenocarcinomas in the uncinate process of pancreas.There were 16 males and 10 females aging from 30 to 75 years old [medium age(55.0±13.0)years old].Eleven of 26 patients were combined with portal vein-superior mesenteric vein resection. The effect and safety of this procedure were analyzed retrospectively.Results There was no operative mortality in all patients.The pathological examination showed that all the incisal margins were negative.After a follow-up of 7 to 45 months,the pain relief was occurred in all patients.The 1-year,2-year accumulated survival rates were 72.2%.and 48.1%.respectively.Conclusions Full length SMA isolation and the mesentery resection in extended pancreaticodudenectomy are safe and effective.The procedure is also benefit for the patients in improving the survival rate and quality of life.