Kawarada Y, Das B C, Naganuma T, Isaji S
First Department of Surgery, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
J Hepatobiliary Pancreat Surg. 2001;8(3):224-9. doi: 10.1007/s005340170021.
The rate of curative resection of pancreatic cancer has increased as a result of extended operations, but this has not led to any significant improvement in postoperative outcome. No definite conclusions were drawn in retrospective studies comparing outcome after standard and extended operations, and there was almost no difference in outcome between the two groups in a recent prospective randomized study. In addition, extended procedures are very stressful operations that, in most instances, impair the patient's quality of life (QOL). As a result, the need for performing extended surgery to treat pancreatic cancer has come into question. The outcome of advanced cancer in patients in whom curative resection cannot be achieved by extended operations is extremely poor, and we believe that, in such patients, priority should be given to QOL, by selecting bypass or limited operations instead. It is hoped that the value of extended surgery will be clarified by a very carefully planned multicenter prospective randomized study in the future.
由于扩大手术的开展，胰腺癌的根治性切除率有所提高，但这并未使术后结局得到任何显著改善。在比较标准手术和扩大手术后结局的回顾性研究中，未得出明确结论，且在最近一项前瞻性随机研究中，两组的结局几乎没有差异。此外，扩大手术是极具压力的手术，在大多数情况下会损害患者的生活质量（QOL）。因此，进行扩大手术治疗胰腺癌的必要性受到质疑。对于那些无法通过扩大手术实现根治性切除的晚期癌症患者，其结局极差，我们认为，在此类患者中，应优先考虑生活质量，选择旁路手术或有限手术。希望未来通过一项精心规划的多中心前瞻性随机研究来阐明扩大手术的价值。
