摘要
目的 探讨腹腔镜手术治疗胰腺神经内分泌肿瘤（pNENs）的临床疗效.方法 回顾性分析2005年3月至2014年6月浙江大学医学院附属邵逸夫医院收治的31例行腹腔镜手术治疗pNENs患者的临床资料.根据肿瘤位置及大小选择具体术式.采用电话和门诊方式进行随访,随访时间截至2014年8月.结果 31例患者成功完成腹腔镜手术,其中腹腔镜胰腺肿瘤剜除术4例,腹腔镜胰十二指肠切除术2例,腹腔镜中段胰腺切除术2例,腹腔镜保留脾脏胰体尾切除术6例,腹腔镜胰体尾联合脾脏切除术17例.手术时间为（205±74） min,术中平均出血量为125 mL（10～1 000 mL）,术中输血率为9.7％ （3/31）.术后平均下床活动时间为2d（1 ～3d）,术后肛门平均排气时间为3 d（1～4d）,术后平均进食流质饮食时间为3d（1 ～7 d）,术后平均住院时间为10 d（5 ～63 d）.术后并发症发生率为35.5％（11/31）,均经对症处理后痊愈.无围手术期死亡患者.31例患者获得术后随访.中位随访时间为21个月（5～111个月）.1例患者术后即出现胰腺外分泌功能不足表现;3例患者术后1个月出现糖尿病;1例患者术后1年因肿瘤广泛转移死亡;1例患者术后3年再次出现Whipple三联征,经MRI检查及术中超声证实胰头、胰尾部多发肿瘤.其余患者未出现肿瘤复发或转移.结论 腹腔镜手术治疗pNENs创伤小、恢复快,近、远期疗效好,安全可行.其具体术式选择主要取决于肿瘤的位置和大小.
Objective To investigate the clinical efficacy of laparoscopic resection for pancreatic neuroendocrine neoplasms （pNENs）.Methods The clinical data of 31 patients who received laparoscopic resection for pNENs at the Sir Run Run Show Hospital of Zhejiang University from March 2005 to June 2014 were retrospectively analyzed.The surgical procedure was selected according to the location and size of the pNENs.Patients were followed up via phone call or out-patient examination till August 2014.Results Laparoscopic resection was successfully carried out on all the 31 patients,including laparoscopic enucleation in 4 patients,laparoscopic pancreatoduodenectomy in 2 patients,laparoscopic central pancreatectomy in 2 patients,laparoscopic spleenpreserving distal pancreatectomy in 6 patients and laparoscopic distal pancreatosplenectomy in 17 patients.The operation time,volume of intraoperative blood loss and blood transfusion rate were （205 ± 74）minutes,125 mL （10-1 000 mL） and 9.7% （3/31）,respectively.The time for out-off-bed activity,time to anal exsufflation,time for fluid diet intake and duration of postoperative hospital stay were 2 days （range,1-3 days）,3 days （range,1-4 days）,3 days （range,1-7 days） and 10 days （range,5-63 days）.The incidence of postoperative complications was 35.5% （11/31）,and the complications were cured after symptomatic treatment.No patient died perioperatively.Thirty-one patients were followed up with the follow-up rate of 100.0%.The median time for followup was 21 months （range,5-111 months）.One patient had symptom of pancreatic exocrine insufficiency after the operation; 3 patients had diabetes at postoperative month 1 ; 1 patient died of tumor metastases at postoperative year 1 ; 1 patient had Whipple＆#39;s triad at postoperative year 3,and was confirmed with tumors in the head and tail of the pancreas by magnetic resonance imaging.No tumor recurrence or metastasis was detected in the other patients.Conclusions Laparoscopic resection is safe and feasibl
出处
《中华消化外科杂志》
CAS
CSCD
北大核心
2014年第10期776-779,共4页
Chinese Journal of Digestive Surgery
基金
浙江省重大科技专项（2011C13036-2）
浙江省医学重点学科基金（11-CX21）
