海德堡三角清扫对胰头癌切除手术疗效的影响
The effect of Heidelberg triangle dissection on the prognosis of patients after pancreatic head cancer resection
王振勇 1刘子琪 2孟宇 1李金超 1张雷 1吕文浩 1刘金来 1刘汝海1
作者信息
- 1. 沧州市中心医院肝胆胰外一科,沧州 061000
- 2. 河北医科大学附属沧州市中心医院,沧州 061000
- 折叠
摘要
目的 评估清扫海德堡三角在胰头癌手术治疗中的近远期疗效.方法 回顾性分析2017年1月至2020年1月沧州市中心医院收治的97例行胰十二指肠切除术胰头癌患者的临床病理资料,通过倾向性评分匹配后33例纳入海德堡组,36例纳入对照组.结果 匹配后,与对照组相比,海德堡组在手术相关一般情况与术后并发症等方面差异无统计学意义(均P＞0.05),手术切缘＞1 mm例数更多(81.8％比58.3％,P=0.034)、淋巴结清扫总数明显增加(11.24±2.35比9.50±2.76,P=0.006).生存分析中,海德堡组术后12个月累积复发率(0.182±0.067比0.444±0.083,P=0.023)、18个月累积复发率(0.424±0.086比0.667±0.079,P=0.024)优于对照组,且海德堡组局部复发率较对照组明显降低(15.3％比36.1％,P=0.037),但两组患者总生存时间差异无统计学意义(P＞0.05).结论 胰头癌根治术中清扫海德堡三角,可降低局部复发概率,但对总生存时间没有明显影响.
Abstract
Objective To evaluate the short-term and long-term efficacy of Heidelberg triangle dissection in surgical treatment for pancreatic head cancer.Methods The clinicopathological data of 97 patients with pancreatic head cancer who underwent pancreaticoduodenectomy at Cangzhou Central Hospital from Jan 2017 to Jan 2020 were retrospectively analyzed.After propensity score matching,33 patients were included into the Heidelberg group and 36 patients in the control group.Results There were no significant difference between Heidelberg group and control group in preoperative general conditions and postoperative major complications,while there were more cases with safe surgical margin＞1 mm(81.8％vs.58.3％,P=0.034)and a significantly higher total number of lymph node dissection(11.24±2.35 vs.9.50±2.76,P=0.006).In the survival analysis,the cumulative recurrence rate at 12 months(0.182±0.067 vs.0.444±0.083,P=0.023)and 18 months(0.424±0.086 vs.0.667±0.079,P=0.024)were better off in the Heidelberg group,and the local recurrence rate in the Heidelberg group was significantly lower than that in the control group(15.3％vs.36.1％,P=0.037).However,there was no statistical difference in the overall survival time between the two groups.Conclusion Dissection of Heidelberg triangle in radical resection of pancreatic head cancer reduces tumor local recurrence,while fails to provide survival benefit.
关键词
胰腺肿瘤/肿瘤复发,局部/海德堡三角Key words
Pancreatic neoplasms/Neoplasm recurrence,local/Heidelberg triangle引用本文复制引用
基金项目
沧州市重点研发计划指导项目(204106116)
出版年
2024
NETL
NSTL
维普
万方数据