Kiil Jørgen, Henneberg Eskild W
Viborg Sygehus, Organkirurgisk Afdeling, Afsnit for Kirurgi og Karkirurgi, Viborg.
Ugeskr Laeger. 2006 Apr 10;168(15):1529-33.
The outcomes of cardio-oesophageal resection, gastric resection, total gastrectomy and Whipple's operation in a low-volume hospital over a decade are presented.
Thirty-seven patients were followed for five years after a cardio-oesophageal resection, 21 after a Billroth II resection, 15 after total gastrectomy and 28 after a Whipple's operation. Mortality and morbidity rates, post-operative in-hospital period and long-term survival were measured.
Cardio-oesophageal resection: The morbidity rate was 19%, the mortality rate was 11%, and the median post-operative stay in hospital was 11 days. The five-year survival rate based on death from cancer was 37% and from all causes 32%. Gastric resection and gastrectomy: The morbidity rate was 14%, the mortality rate was 3%, and the median post-operative period in hospital was 9 days after gastric resection and 11 days after gastrectomy. The five-year survival rate based on death from was cancer 55% and from all causes 37%. Whipple's procedure: The morbidity rate was 17%, the mortality rate was 4% and the median post-operative stay in hospital was 10 days. The survival rate based on death from cancer was 77% and from all causes was 54% after five years for cancer of the ampulla of Vater, and 27% and 31% after three years for pancreatic head carcinoma.
Major gastric and pancreatic operations can be performed in a low-volume hospital with satisfactory results.
本文介绍了一家小规模医院在十年间进行的心食管切除术、胃切除术、全胃切除术和惠普尔手术的结果。
对37例行心食管切除术、21例行毕罗Ⅱ式切除术、15例行全胃切除术和28例行惠普尔手术的患者进行了为期五年的随访。测量了死亡率、发病率、术后住院时间和长期生存率。
心食管切除术：发病率为19%，死亡率为11%，术后中位住院时间为11天。基于癌症死亡的五年生存率为37%，全因死亡的五年生存率为32%。胃切除术和全胃切除术：发病率为14%，死亡率为3%，胃切除术后中位住院时间为9天，全胃切除术后为11天。基于癌症死亡的五年生存率为55%，全因死亡的五年生存率为37%。惠普尔手术：发病率为17%，死亡率为4%，术后中位住院时间为10天。对于壶腹癌，五年后基于癌症死亡的生存率为77%，全因死亡的生存率为54%；对于胰头癌，三年后基于癌症死亡的生存率为27%，全因死亡的生存率为31%。
在小规模医院可以进行主要的胃和胰腺手术，且结果令人满意。
