Lin Qing, Tan Langping, Zhou Yu, Zhou Quanbo, Chen Rufu
Department of Biliary and Pancreatic Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510080, China.
Chin J Cancer Res. 2016 Aug;28(4):429-34. doi: 10.21147/j.issn.1000-9604.2016.04.06.
To explore the clinical value of the radical nerve dissection (RND) for the carcinoma of head of pancreas (CHP).
The clinical and pathological data of 30 CHP patients who underwent RND in our hospital were retrospectively analyzed, with an attempt to explore the safety and short-term efficacy of this procedure.
Among these 30 patients, the operative time was (351±61) min, the intra-operative blood loss was 350 (range, 300-600) mL, and the grades B and C pancreatic fistula was 23.33%. During the follow-up (range, 2-30 months; median: 17 months), the 1-year survival rate was 63.33% and the 1-year disease-free survival rate was 56.67%. Among the 23 patients (76.66%) with positive extra-pancreatic perineural invasion (PNI), the 1-year casefatality rate was 34.78%, which was not significantly different from that (28.57%) of patients with negative PNI (P=0.760).
Our results suggested potential advantages of RND in the fields of surgery-associated risk and prognosis compared with the Whipple operation in the treatment of CHP. Due to the low sample size of this study, further well-designed research of large sample size is needed.
探讨根治性神经清扫术（RND）治疗胰头癌（CHP）的临床价值。
回顾性分析我院30例行RND的CHP患者的临床及病理资料，旨在探讨该手术的安全性及短期疗效。
这30例患者中，手术时间为（351±61）分钟，术中出血量为350（范围300 - 600）毫升，B级和C级胰瘘发生率为23.33%。随访期间（范围2 - 30个月；中位数：17个月），1年生存率为63.33%，1年无病生存率为56.67%。在23例（76.66%）胰外神经周围侵犯（PNI）阳性的患者中，1年病死率为34.78%，与PNI阴性患者的病死率（28.57%）相比差异无统计学意义（P = 0.760）。
我们的结果表明，与Whipple手术相比，RND在治疗CHP的手术相关风险和预后方面具有潜在优势。由于本研究样本量较小，需要进一步开展设计良好的大样本研究。
