关键词: Laparoscopy pancreatic cancer (PC) pancreaticoduodenectomy (PD) propensity score matching (PSM)

来  源:   DOI:10.21037/gs-23-538   PDF(Pubmed)

Abstract:
UNASSIGNED: Open surgery is gradually replaced by minimally invasive surgery, but few studies have reported the feasibility of laparoscopic pancreaticoduodenectomy (LPD) combined with vascular resection and reconstruction. The present study compared the efficacy of LPD with open pancreaticoduodenectomy (OPD) combined with portal vein/superior mesenteric vein (PV/SMV) resection and reconstruction for pancreatic cancer.
UNASSIGNED: The clinical data of patients who underwent PD combined with PV/SMV resection and reconstruction from March 2016 to August 2022 at our institution were retrospectively analyzed. The perioperative outcomes and survival outcomes were compared after propensity score matching (PSM).
UNASSIGNED: The original cohort included 64 patients. Sixteen pairs of patients were obtained by 1:1 PSM. The intraoperative blood loss was greater in the OPD group than in the LPD group (550 vs. 200 mL, P=0.04), and the PV clamp time was longer in the LPD group than in the OPD group (29.4 vs. 18.8 min, P<0.001). There was no significant difference in the incidence of postoperative complications. The median overall survival and progression-free survival were comparable between the two groups (P>0.05).
UNASSIGNED: LPD combined with PV/SMV resection and reconstruction is safe and feasible in selected patients and results in similar perioperative outcomes and prognosis as open surgery.
摘要:
开放手术逐渐被微创手术所取代,但很少有研究报道腹腔镜胰十二指肠切除术(LPD)联合血管切除和重建的可行性。本研究比较了LPD与开放胰十二指肠切除术(OPD)联合门静脉/肠系膜上静脉(PV/SMV)切除和重建胰腺癌的疗效。
回顾性分析2016年3月至2022年8月在我院接受PD合并PV/SMV切除重建的患者的临床资料。倾向评分匹配(PSM)后比较围手术期结局和生存结局。
原始队列包括64名患者。通过1:1PSM获得了16对患者。OPD组的术中失血量大于LPD组(550vs.200mL,P=0.04),LPD组的PV钳夹时间长于OPD组(29.4vs.18.8min,P<0.001)。术后并发症发生率差异无统计学意义。两组中位总生存期和无进展生存期具有可比性(P>0.05)。
LPD联合PV/SMV切除和重建在选定的患者中是安全可行的,并导致与开放手术相似的围手术期结果和预后。
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