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胰腺囊性肿瘤患者可从多学科团队管理中获益:中国学术中心的经验。

Patients with pancreatic cystic neoplasms can benefit from management of multidisciplinary team: Experience from a Chinese academic center.

机构信息

Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China.

Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China.

出版信息

Pancreatology. 2018 Oct;18(7):799-804. doi: 10.1016/j.pan.2018.07.010. Epub 2018 Jul 31.

Abstract

BACKGROUND

Pancreatic cystic neoplasms (PCNs) are a spectrum of neoplasms that can be benign or malignant. The accuracy of diagnosis is critical for this disease since different types of PCNs are treated differently using various modalities. The use of a multidisciplinary team (MDT) has been shown to improve the management and outcomes of various diseases. We aimed to determine the performance of MDT in the management of PCNs.

METHODS

We retrospectively reviewed 167 pathologically-proven PCN patients and divided them among three groups according to their surgical data and treatment modalities: 1) historical control group (HC group); 2) concurrent control group (CC group); and 3) MDT group. The composition of subtypes of PCNs, preoperative diagnostic accuracy, postoperative complications, and postoperative hospital stay were compared among the three groups.

RESULTS

The incidence of SCN reduced in the MDT group, while the incidence of IPMN was much higher (P < 0.05). MDT management significantly improved the accuracy of preoperative diagnosis (71.7%) and also increased the individual diagnostic accuracies of ultrasound, CT, and MRI/MRCP. Postoperative pancreatic fistula was significantly reduced in the MDT group (28.3%; P < 0.001). Furthermore, the mean hospital stay after surgery in the MDT group (10.37 days) was shorter than those of the other two groups (27.35 days in HC group, and 19.28 days in CC group; P < 0.05).

CONCLUSION

For patients with PCN, MDT management was associated with an improvement in the overall accuracy of preoperative diagnosis, a lower incidence postoperative morbidity, and decreased length of hospital stay.

摘要

背景

胰腺囊性肿瘤(PCN)是一组可能为良性或恶性的肿瘤。由于不同类型的 PCN 需要采用不同的方法进行治疗,因此准确的诊断对于该疾病至关重要。多学科团队(MDT)的应用已被证明可以改善各种疾病的管理和结局。我们旨在确定 MDT 在 PCN 管理中的表现。

方法

我们回顾性分析了 167 例经病理证实的 PCN 患者,并根据其手术数据和治疗方式将其分为三组:1)历史对照组(HC 组);2)同期对照组(CC 组);3)MDT 组。比较三组患者的 PCN 亚型构成、术前诊断准确性、术后并发症和术后住院时间。

结果

MDT 组的 SCN 发生率降低,而 IPMN 的发生率明显更高(P < 0.05)。MDT 管理显著提高了术前诊断的准确性(71.7%),并提高了超声、CT 和 MRI/MRCP 的个体诊断准确性。MDT 组术后胰瘘显著减少(28.3%;P < 0.001)。此外,MDT 组术后住院时间(10.37 天)明显短于 HC 组(27.35 天)和 CC 组(19.28 天;P < 0.05)。

结论

对于 PCN 患者,MDT 管理可提高术前诊断的整体准确性,降低术后发病率,并缩短住院时间。

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