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首页> 外文期刊>BMC Surgery >Transduodenal ampullectomy provides a less invasive technique to cure early ampullary cancer
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Transduodenal ampullectomy provides a less invasive technique to cure early ampullary cancer

机译：经十二指肠壶腹部切除术提供了一种微创技术来治疗早期壶腹癌

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Background The aim of this study was to evaluate the clinical efficiency of transduodenal ampullectomy (TDA) compared to conventional pancreatoduodenectomy (PD) in patients with early ampullary cancers. Methods We carried out a retrospective study by reviewing the medical records of 43 patients with early ampullary cancer who underwent either TDA or PD from January 2001 to December 2014. TDA and PD were performed on 22 patients and 21 patients, respectively. Clinical data, perioperative clinical outcomes and prognosis were evaluated. The median follow-up was 75 (range, 38–143) months. Results The sensitivity of intraoperative frozen resection was 100?% (4/4) and 94.9?% (37/39) in patients with pTis and pT1 tumors compared to final histologic diagnoses. The 5-year survival rate of patients with early ampullary cancer was 77.3?% in TDA group and 75.9?% in PD group ( P =?0.927). Patients with lymph node metastasis presented a shorter 5-year survival rate ( P =?0.014). TDA was associated with lower surgical morbidity ( P =?0.033), estimated blood loss ( P =?0.002), medical cost ( P =?0.028) compared to PD. No pancreatic fistula and surgical mortality occurred in TDA group. Conclusions TDA could produce satisfactory clinical efficiency in patients fulfilled the following criteria simultaneously: pTis or pT1 stage, tumor size?≤?2?cm, without lymph node metastasis. To achieve favorable outcomes, intraoperative frozen section examinations should be reliable and resection margins should be negative.
机译：背景技术这项研究的目的是评估与早期常规胰十二指肠切除术（PD）相比，经十二指肠壶腹部切除术（TDA）的临床疗效。方法我们回顾性研究了2001年1月至2014年12月期间接受TDA或PD治疗的43例早期壶腹癌患者的病历，分别对22例和21例患者进行了TDA和PD。评价临床数据，围手术期临床结局和预后。中位随访时间为75（38-143）个月。结果与最终的组织学诊断相比，pTis和pT1肿瘤患者术中冷冻切除术的敏感性分别为100％（4/4）和94.9％（37/39）。早期壶腹癌患者的5年生存率在TDA组为77.3％，在PD组为75.9％（P = 0.927）。淋巴结转移患者的5年生存率较短（P =？0.014）。与PD相比，TDA与较低的手术发病率（P =？0.033），估计的失血量（P =？0.002），医疗费用（P =？0.028）有关。 TDA组未发生胰瘘和手术死亡。结论TDA可同时满足以下标准：pTis或pT1分期，肿瘤大小≤2？cm，无淋巴结转移，临床疗效满意。为了取得良好的效果，术中冷冻切片检查应可靠，切除切缘应为负。

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