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接受腹腔镜检查的胃肠道恶性肿瘤患者的穿刺孔转移

Port-site metastases in patients undergoing laparoscopy for gastrointestinal malignancy.

作者信息

Cook T A, Dehn T C

机构信息

Department of Surgery, Royal Berkshire Hospital, Reading, UK.

出版信息

Br J Surg. 1996 Oct;83(10):1419-20. doi: 10.1002/bjs.1800831031.

Abstract

Laparoscopic colonic resection and laparoscopy for the assessment of malignant disease have been advocated. Metastatic deposits at port sites are recognized but the incidence of these is poorly defined. Forty-six patients, of median age 65 (range 19-90) years, with gastrointestinal malignancy underwent laparoscopy. Eighteen patients died a median of 4 (range 1-28) months after laparoscopy, four following colonic resection and 14 with gastro-oesophageal malignancy; ten had undergone resection. Median follow-up of the 28 survivors is 8 (range 2-39) months. Five of the 46 patients developed port-site recurrence giving an early incidence of port-site recurrence in this cohort of patients of 11 per cent. Five of 20 patients with tumour involving serosal surfaces developed port-site recurrence compared with none of 26 without serosal involvement (P = 0.022, Fisher's exact test). Port-site recurrence may be related to serosal involvement with tumour.

摘要

腹腔镜结肠切除术以及用于评估恶性疾病的腹腔镜检查已得到提倡。端口部位的转移瘤已得到确认,但这些转移瘤的发生率尚不明确。46例中位年龄为65岁(范围19 - 90岁)的胃肠道恶性肿瘤患者接受了腹腔镜检查。18例患者在腹腔镜检查后中位4个月(范围1 - 28个月)死亡,4例在结肠切除术后死亡,14例因胃食管恶性肿瘤死亡;其中10例接受了切除术。28名幸存者的中位随访时间为8个月(范围2 - 39个月)。46例患者中有5例发生端口部位复发,该队列患者的端口部位复发早期发生率为11%。20例肿瘤累及浆膜表面的患者中有5例发生端口部位复发,而26例未累及浆膜的患者中无一例发生端口部位复发(P = 0.022,Fisher精确检验)。端口部位复发可能与肿瘤累及浆膜有关。

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