Yonemura Y, Kamata T, Shimizu K, Kosaka T, Yamaguchi A, Miwa K, Miyazaki I
School of Medicine, Kanazawa University, Japan.
Nihon Geka Gakkai Zasshi. 1991 Mar;92(3):308-12.
In the last 16 years we employed pancreaticodudenectomy (PD) on 27 patients with cancers of the distal third of the stomach, associated with duodenal invasion, invasion to pancreatic head, or n3 metastasis. More recently, total gastrectomy and total pancreatectomy combined with heterotopic autotransplantation of the distal pancreas (TGTP) was performed in 7 patients with n4 metastases. These cases were compared with 56 patients who underwent subtotal gastrectomy (SG) in the same period. When the survival rates were compared, PD provided better long-term results than SG, especially on the patients with tumors infiltrating into the pancreas head. On the contrary, there was no significant survival advantage in patients with duodenal invasion or n3 metastasis between PD group and SG group. TGPT showed the longest survival for the patients with n4 metastasis. These results indicate that PD is a rational and safe method for the treatment of gastric cancer infiltrating into the pancreas head. In addition, TGTP may be the most radical procedure for the treatment of gastric cancer with n4 metastases.
在过去16年里，我们对27例胃远端三分之一部癌患者进行了胰十二指肠切除术（PD），这些患者伴有十二指肠侵犯、胰头侵犯或N3转移。最近，对7例N4转移患者进行了全胃切除术、全胰切除术并结合远端胰腺异位自体移植（TGTP）。将这些病例与同期接受胃大部切除术（SG）的56例患者进行比较。比较生存率时，PD比SG提供了更好的长期结果，尤其是对肿瘤浸润至胰头的患者。相反，PD组和SG组中伴有十二指肠侵犯或N3转移的患者在生存方面没有显著优势。TGPT对N4转移患者显示出最长的生存期。这些结果表明，PD是治疗浸润至胰头的胃癌的一种合理且安全的方法。此外，TGTP可能是治疗伴有N4转移的胃癌的最彻底手术。
