Song Zhen Guo, Hao Ji Hui, Gao Song, Gao Chun Tao, Tang Yong, Liu Jing Chen
Department of Pancreatic Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China; Department of Anesthesiology and Operating Center, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
J Dig Dis. 2014 Oct;15(10):561-9. doi: 10.1111/1751-2980.12170.
This study aimed to investigate the efficacy and safety of palliative bypass surgery combined with cryoablation in treating patients with advanced pancreatic cancer and compare this combination therapy with palliative bypass surgery alone.
Medical records of 118 patients with advanced pancreatic cancer who received palliative bypass surgery combined with cryoablation (the combination treatment group) or bypass surgery alone (the bypass surgery alone group) at the Department of Pancreatic Cancer, Tianjin Medical University Cancer Institute and Hospital (Tianjin, China) were retrospectively reviewed. Their baseline and peri-operative parameters were collected and compared.
In both groups abdominal distension and pain was significantly ameliorated after treatment. Preoperative jaundice was more common in the bypass surgery group while backache was more frequent in the combination treatment group, which were both relieved by treatment. The pre-operative serum bilirubin level was higher in the bypass surgery group and was decreased significantly after treatment. However, a significant reduction in tumor size and serum carbohydrate antigen 19-9 level was found only in the combination treatment group. There was no significant difference in the incidence of postoperative complications and prognosis between the two groups.
Cryoablation can reduce tumor size and relieve the patients' symptoms and signs such as abdominal discomfort and backache, although it could not improve the patients' prognosis significantly. It is a safe and efficient modality when combined with bypass surgery for patients with advanced pancreatic cancer.
本研究旨在探讨姑息性旁路手术联合冷冻消融治疗晚期胰腺癌患者的疗效和安全性，并将这种联合治疗与单纯姑息性旁路手术进行比较。
回顾性分析天津医科大学肿瘤医院（中国天津）胰腺癌科118例接受姑息性旁路手术联合冷冻消融（联合治疗组）或单纯旁路手术（单纯旁路手术组）的晚期胰腺癌患者的病历。收集并比较他们的基线和围手术期参数。
两组治疗后腹胀和疼痛均明显改善。术前黄疸在单纯旁路手术组更常见，而背痛在联合治疗组更频繁，治疗后均得到缓解。单纯旁路手术组术前血清胆红素水平较高，治疗后明显降低。然而，仅在联合治疗组发现肿瘤大小和血清糖类抗原19-9水平显著降低。两组术后并发症发生率和预后无显著差异。
冷冻消融可缩小肿瘤大小，缓解患者腹部不适和背痛等症状体征，尽管它不能显著改善患者预后。对于晚期胰腺癌患者，与旁路手术联合使用时，它是一种安全有效的治疗方式。
