Nakao A, Kaneko T, Takeda S, Inoue S, Harada A, Nomoto S, Ekmel T, Yamashita K, Hatsuno T
Department of Surgery II, Nagoya University School of Medicine, 65 Tsurumaicho, Showa-ku, Nagoya 466-8550, Japan.
Hepatogastroenterology. 2001 Jul-Aug;48(40):949-52.
BACKGROUND/AIMS: To clarify the indication of extended operation for pancreatic carcinoma, a clinical study was carried out.
From July 1981 to 1999, 196 of 307 (63.8%) patients with pancreatic carcinoma underwent resection of the tumor. Portal vein resection was performed in 145 of these 196 (74.0%) resected cases. The postoperative survival rate was studied according to the operative and histopathological findings.
In spite of the aggressive surgery, there was no patient who survived over 3 years after operation in the group carcinoma-positive on the surgical margins. Patients who survived over 3 years postoperatively were observed in the group of carcinoma-free surgical margins.
The most important indication of extended operation combined with portal vein resection for pancreatic cancer is to obtain surgical cancer-free margins. There is no indication of extended operation for cases in which surgical margins will become cancer-positive, if such an operation is employed.
背景/目的:为明确胰腺癌扩大手术的适应证,开展了一项临床研究。
1981年7月至1999年,307例胰腺癌患者中有196例(63.8%)接受了肿瘤切除术。这196例接受切除术的患者中,145例(74.0%)进行了门静脉切除。根据手术及组织病理学检查结果研究术后生存率。
尽管采取了积极的手术方式,但手术切缘癌阳性组中无患者术后存活超过3年。术后存活超过3年的患者出现在切缘无癌组。
胰腺癌扩大手术联合门静脉切除的最重要适应证是获得无癌手术切缘。如果采用这种手术,对于手术切缘将变为癌阳性的病例,没有扩大手术的适应证。