期刊文献+

T2期胆囊癌腹腔镜胆囊切除术及根治术的可行性分析 被引量:8

Laparoscopic radical cholecystectomy vs open surgery for T2 gallbladder cancer
收藏 分享 导出
摘要 目的探讨腹腔镜胆囊切除术及根治术在他期胆囊癌的可行性与关注点。方法回顾性分析44例病理科医师复核病理明确的T2期患者的临床病理资料,分组比较腹腔镜手术与开腹手术的临床病理资料。结果44例患者中32例患者行腹腔镜胆囊切除术,与开腹胆囊切除术组的种植转移率比较差异无统计学意义(P=1.000)。44例患者中26例行腹腔镜胆囊癌根治术,其余18例行开腹根治术,两组患者的手术时间(P:0.953)、术中出血量(P=0.193)和术后并发症(P=1.000)比较,差异无统计学意义;腹腔镜根治术组住院时间(P=0.048)短于开腹根治术组:两组患者淋巴结送检个数分别为1~12枚,平均(5±4)枚,1~12枚,平均(6±3)枚,差异无统计学意义(P=0.983);2组患者1、3、5年生存率分别为92.3%、70.3%、61.5%和100%、76.3%、69.3%。生存时间比较差异无统计学意义(P=0.473)。结论保证胆囊不破损的前提下先期腹腔镜胆囊切除术不增加12期胆囊癌的种植转移率.完全腹腔镜根治术在部分T2期胆囊癌中是可行的。 Objective To evaluate laparoscopic radical cholecystectomy for T2 gallbladder cancers. Methods A retrospective analysis was made on 44 patients with pathology confirmed T2 gallbladder cancer undergoing laparoscopic vs open radical cholecystectomy. The clinicopathological and follow-up data were compared. Results Laparoscopic cholecystectomy was performed in 32 patients, the implantation metastasis rate of this approach has no statistical differences compared with the open cholecystectomy ( P = 1. 000). 26 patients underwent laparoscopic radical resection and the remaining 18 patients underwent open radical resection. There was no statistical difference in operation time (P = 0. 953), blood loss (P = 0. 193 ) and postoperative complications ( P = 1. 000), but the laparoscopic radical resection group is superior to the open group on postoperative pain grading ( P = 0. 022), ambulation time ( P = 0. 000), nothing per mouth time (P =0. 000) and length of hospital stay (P =0. 048). The mean number of lymph nodes retrieved was 5 +4 (range 1 -12) in the laparoscopic radical group and 6 -+3 (range 1 - 12) in the open group (P = 0.983);the 1, 3, 5 year survival rates was 92.3%, 70.3%, 61.5% and 92.3%, 76.3%, 69.3%, respectively(P =0. 473). Conclusions Initial laparoscopic cholecystectomy does not increase the rate of seeding metastasis in the context of intact gallbladder carcinoma. Totall laparoscopic radical resection is feasible in selected T2 gallbladder cancer patients.
作者 张铃福 侯纯升 徐智 郭丽梅 陶立元 凌晓锋 王立新 修典荣 Zhang Lingfu, Hou Chunsheng, Xu Zhi, Guo Limei, Tao Liyuan, Ling Xiaofeng, Wang Lixin, Xiu Dianrong.( Department of General Surgery, Peking University Third Hospital, Beijing 100191, China)
出处 《中华普通外科杂志》 CSCD 北大核心 2017年第5期389-392,共4页 Chinese Journal of General Surgery
关键词 胆囊肿瘤 胆囊切除术 腹腔镜 Gallbladder neoplasms Cholecystectomy, laparoscopic
作者简介 通信作者:侯纯升,E-mail:chunshenghou@126.com
  • 相关文献

参考文献3

二级参考文献63

  • 1Yeh CN, Jan YY, Chen MF. Management of unsuspected gallbladder carcinoma discovered during or following laparoscopic cholecystectomy. Am Surg, 2004, 70:256-258. 被引量:1
  • 2Suzuki K, Kimura T, Ogawa H. Long-term prognosis of gallbladder cancer diagnosed after laparoscopic cholecystectomy.Surg Endosc, 2000, 14 : 712-716. 被引量:1
  • 3Ouchi K, Mikuni J, Kakugawa Y, et al. Laparoscopic cholecystectomy for gallbladder carcinoma: results of a Japanese survey of 498 patients. J Hepatobiliary Pancreat Surg,2002, 9:256-260. 被引量:1
  • 4de Aretxabala XA, Roa IS, Mora JP, et al. Laparoscopic cholecystectomy:Its effect on the prognosis of patients with gallbladder cancer. World J Surg, 2004, 28:544-547. 被引量:1
  • 5Goetze T, Paolucci V. Does laparoscopy worsen the prognosis for incidental gallbladder cancer?Surg Endosc,2006 20:86-93. 被引量:1
  • 6Z'graggen K, Birrer S, Maurer CA, et al. Incidence of port site recurrence after laparoscopic cholecystectomy for preoperatively unsuspected gallbladder carcinoma. Surgery 1998, 124: 831-838. 被引量:1
  • 7Yamaguchi K,Chigiiwa K,Saiki S,et al.Retrospective analysis of 70 operations for gallbladder carcinoma.Br J Surg,1997,84:200-204. 被引量:1
  • 8Shimada H,Endo I,Togo S,et al.The role of lymph node dissection in the treatment of gallbladder carcinoma.Cancer,1997,79:892-899. 被引量:1
  • 9Chijiiwa K,Nakano K,Ueda J,et al.Surgical treatment of patients with T2 gallbladder carcinoma invading the subserosal layer.J Am Coll Surg,2001,192:600-607. 被引量:1
  • 10Wakai T,Shirai Y,Yokoyama N,et al.Depth of subserosal invasion predicts long-term survival after resection in patients with T2 gallbladder carcinoma.Ann Surg Oncol,2003,10:447-454. 被引量:1

共引文献68

同被引文献54

引证文献8

二级引证文献5

投稿分析

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部 意见反馈