摘要
目的 探讨总结Ｖａｔｅｒ 壶腹癌局部切除的理论依据、复发原因、适应证、术式评价。方法收集并分析国内１９９２～１９９７ 年报告的４８ 例和我院经治的４ 例，共５２ 例局部切除治疗Ｖａｔｅｒ 壶腹癌的临床资料。结果 ５２ 例Ｖａｔｅｒ 壶腹癌行局部切除术，并发症发生率９６ ％ ，手术死亡率３８ ％ 。随访７个月至８ 年，１２ 例复发，其中７ 例切缘有癌组织残存；低分化腺癌３ 例，侵袭性腺癌１ 例；１９ 例死亡（ 包括２ 例手术死亡） ，余生存８ 个月至４ 年。３２ 例无瘤健存７ 个月至８ 年，失访１ 例。结论 Ｖａｔｅｒ 壶腹癌局部切除有一定疗效，其预后与肿瘤大小、侵袭范围和程度、有无淋巴结转移、肿瘤的病理类型和分化程度有关，更与手术切除的切缘是否有癌有关。其创伤小、恢复快、手术并发症及死亡率低，局部切除对高龄、一般情况差。
Objective To study the therapeutic results of patients with carcinoma of ampulla Vater treated by local tumor resection. Methods Four cases of carcinoma of ampulla of Vater treated in our hospital by local tumor resection and 48 cases reported in Chinese medical literature in 1992～1997 were analyzed. Results A total of 52 cases was collected who received local resection of carcinoma of ampulla of Vater. The operative mortality was 3.8% and the morbidity was 9.6%. Recurreuce occurred in 12 cases, of whom 3 had poorly differentiated adenocarcinoma, 7 had their tumor incompletely resected with tumor left at the cutting edge and one had local invasion. In 8 month to 4 years, 19 cases died. Thirty two cases survived for 7 months to 8 years after operation. Conclusion The prognosis of local resection is related not only to tumor size, extent of invasion, metastasis to lymph node, but also to pathologic types and differentiation. It is a treatment of choice for early carcinoma of ampulla of Vater in patients who are at high risk due to old age, poor general condition or severe concurrent diseases.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
1999年第4期305-307,共3页
Chinese Journal of Oncology
关键词
VATER壶腹癌
手术后并发症
预后
外科手术
Carcinoma of ampulla of Vater/surgery Postoperative complications Prognosis
