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腹腔镜分期在胰腺癌中的疗效。

Efficacy of Staging Laparoscopy for Pancreatic Cancer.

机构信息

Department of Gastroenterological Surgery, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan

Department of Gastroenterological Surgery, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan.

出版信息

Anticancer Res. 2020 Feb;40(2):1023-1027. doi: 10.21873/anticanres.14037.

Abstract

BACKGROUND/AIM: Preoperative evaluation of resectability of pancreatic cancer (PC) is difficult, so that staging laparoscopy (SL) has come to be used for detecting occult metastases. We aimed to evaluate the prognostic impact of SL in comparison with exploratory laparotomy (EL) in unresectable PC.

PATIENTS AND METHODS

Between 2010 and 2016, 57 patients with PC underwent SL after conventional tumor staging. Patient characteristics, operative findings and survival rates were compared between SL and EL group.

RESULTS

Twenty patients (35%) were identified as having unresectable factors in SL group. In contrast, laparotomy showed unresectable factors in 8 patients who did not receive preoperative SL (EL group). The time between the surgery to the induction of chemotherapy was significantly shorter in the SL group (mean=6 days, range=2-17) than in the EL group (mean=10 days, range=6-15). There was no significant difference in overall survival between the two groups; however, EL was associated with shorter survival in the early postoperative period.

CONCLUSION

SL was associated with a shorter time interval to chemotherapy and lead to the prevention of unnecessary laparotomy.

摘要

背景/目的:胰腺癌(PC)的可切除性术前评估较为困难,因此采用腹腔镜检查(SL)来检测隐匿性转移。本研究旨在评估与剖腹探查术(EL)相比,SL 对不可切除 PC 的预后影响。

患者和方法

2010 年至 2016 年间,57 例 PC 患者在常规肿瘤分期后接受了 SL。比较 SL 组和 EL 组的患者特征、手术发现和生存率。

结果

SL 组有 20 例(35%)患者被确定为存在不可切除因素。相比之下,在未接受术前 SL 的 8 例患者中(EL 组),剖腹探查显示存在不可切除因素。SL 组(平均 6 天,范围 2-17)的手术到诱导化疗的时间明显短于 EL 组(平均 10 天,范围 6-15)。两组的总生存率无显著差异;然而,EL 与术后早期的较短生存率相关。

结论

SL 与化疗的时间间隔更短,并可避免不必要的剖腹手术。

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