Application of superior mesenteric artery sweeping in radical surgery of pancreatic cancer
[Objective]To observe the effect of superior mesenteric artery(SMA)sweeping in the radical operation of pancreatic cancer.[Methods]This study is a prospective study.Ninety patients with pancreatic cancer who were admitted from May 2021 to October 2022 were selected as the subjects.They were randomly divided into the routine group(45 cases)and the experimental group(45 cases)by computer.Both groups were treated with radical surgery for pancreatic cancer.Routine lymph node dissection was performed in the routine group,and the experimental group was performed with peripheral lymph node dissection of the superior mesenteric artery during the operation.All patients were followed up for one year after the operation.The perioperative clinical indicators,short-term efficacy,and short-term prognosis between two groups of patients were compared.[Results]Under different lymph node dissection ranges,the surgical time and intraoperative lymph node dissection number in the experimental group were 335.25±20.61 minutes and 11.42±3.31 pieces,higher than the conventional group(320.33±20.41 minutes and 9.25±1.36 pieces)(P＜0.05).The intraoperative bleeding volume,intraoperative blood transfusion rate,postoperative recovery time for exhaust,recovery time for eating,and hospital stay in the experimental group were[350.25±20.77 mL,17.78％(8/45),6.25±1.28 h,7.41±1.36 h,and 10.25±2.36 d],slightly higher than the conventional group[345.66±20.77 mL,13.33％(6/45),5.82±1.36 h,6.93±1.49 h,and 9.85±1.27 d](P＞0.05).The CEA,CA199,and CA242 of the experimental group were 260.35±20.41 ng/mL,240.33±20.35 U/mL,and 345.26±20.55 IU/mL,slightly lower than the conventional group(262.35±20.72 ng/mL,243.11±20.36 U/mL,and 347.35±20.66 IU/mL).The ORR and DCR of the experimental group were 84.44％(38/45)and 88.89％(40/45),slightly higher than the conventional group[80.00％(36/45)and 82.22％(37/45)](P＞0.05).The PFS rate,OS rate,median PFS,and median OS of the experimental group within one year were 71.11％(32/45),77.78％(35/45),9.29±1.33 months,and 10.41±2.23 months,higher than the conventional group[55.56％(25/45),62.22％(28/45),8.33±1.25 months,and 9.21±1.47 months].The recurrence rate of the disease within one year was 8.89％(4/45),lower than the conventional group's 26.67％(12/45)(P＜0.05).The incidence of complications in the experimental group was 13.33％(6/45),slightly higher than 11.11％(5/45)of the conventional group(P＞0.05).[Conclusion]Peripheral dissection of superior mesenteric artery can expand the scope of lymph node dissection and increase the number of lymph nodes dissection in patients with pancreatic cancer undergoing radical surgery.It can effectively reduce the risk of disease recurrence,improve the survival rate and prolong the life cycle without affecting the short-term efficacy and increasing the risk of surgery.
pancreatic cancerradical resection of pancreatic cancercomplete circumferential dissection of the superior mesenteric arteryrecent therapeutic effectspostoperative complicationssurvival situation
万方数据
维普
