摘要
目的探讨扩大根治术用于治疗中晚期胆囊癌的疗效及安全性。方法将60例中晚期胆囊癌患者根据手术方式的不同分为标准根治术13例,扩大根治术20例,姑息性手术19例,剖腹探查术8例。观察不同术式的并发症。采用电话和门诊随访2年,比较不同术式患者的1年和2年生存率。结果标准根治术、扩大根治术、姑息性手术和剖腹探查术的并发症发生率分别为7.7%、20.0%、10.5%和0.0%。Ⅲ期、Ⅳ期患者的的中位生存时间分别为6个月和5个月。Ⅲ期、Ⅳ期患者的1年和2年生存率分别为30.8%、15.4%,6.4%、4.3%。不同分期的胆囊癌患者生存率比较,差异无统计学意义(χ~2=0.255,P=0.133)。扩大根治术患者Ⅲ期和Ⅳ期的中位生存时间为12个月和10个月。在Ⅲ、Ⅳ期胆囊癌患者中,行不同术式患者生存率之间差异有统计学意义(χ~2=10.036,P=0.018;χ~2=15.829,P=0.001)。结论胆囊癌扩大根治术治疗中晚期胆囊癌可显著延长患者术后生存时间,但并发症发生率较高。临床上施行胆囊癌扩大根治术治疗中晚期胆囊癌时应严格遵循手术适应证。
Objective To explore the curative effect and safety of extended radical operation in the treatment of ad- vanced gallbladder carcinoma. Methods 60 cases of advanced gallbladder carcinoma clinical data were selected. According to the different surgical methods, 13 cases received standard radical operation ,20 cases received extended radical operation, 19 cases received palliative operation and 8 cases of laparotomy. To observe the complications of different operation methods. 1-and 2-year survival rates of patients with different surgical methods were compared by telephone and outpatient follow-up for 2 years. Results The rates of complications of standard radical masteetomy,extended radical mastectomy, palliative operation and laparotomy were 7.7% ,20.0%, 10.5% and 0%, respectively. The median survival time were 6 months and 5 months in patients with stage Ⅲ and Ⅳ ,respectively. The 1-and 2-year survival rates of patients with stage Ⅲ and stage Ⅳ were 30.8%, 15.4% ,6.4%, and 4.3% ,respectively. In different stages of the survival of patients with gallbladder cancer rate comparison, the difference was not statistically significant （ χ^2=0. 255 ,P = 0. 133 ）. The median survival time was 12 months and 10 months in patients with Ⅲ and Ⅳ after extended radical masteetomy. In stage Ⅲ and Ⅳ patients with carcinoma of gallbladder, the differences in survival rate between different operation methods had statistical significance （χ^2 = 10.036,P = 0. 018;chi square χ^2= 15. 829, P = 0. 001 ）. Conclusion The extended radical operation in the treatment of advanced gallbladder carcinoma can significantly prolong the postoperative survival time,but the incidence of complications is high. In the clinical treatment of patients with middle and advanced stage gallbladder carcinoma, surgical indications should be strictly followed.
出处
《实用癌症杂志》
2017年第10期1677-1680,共4页
The Practical Journal of Cancer
关键词
胆囊癌
扩大根治术
中晚期
生存率
Gallbladder carcinoma
Extended radical mastectomy
Middle and late stage
Survival rate
