摘要
胰体尾癌的手术治疗强调根治原则。手术切缘阴性和区域淋巴结清扫是手术根治的重要内容。近年来，西方学界更新了R0切缘的定义。Strasberg等倡导的根治性顺势胰体尾联合脾切除有助于提高阴性切缘率。扩大根治术虽能获得阴性切缘，但会增加手术并发症及病死率，应审慎施行。淋巴结转移与患者预后密切相关，尚无研究表明扩大的淋巴结清扫可带来生存获益，其于肿瘤分期及预后判断的意义更大。胰体尾癌的腹腔镜切除已有小样本的报道，其与传统开腹手术的优劣仍存在争议。手术仍是目前可能治愈这一疾病的手段。强调手术切除的根治性，将使更多胰体尾癌患者从手术治疗中获益。
Radical resection is crucial in the surgical treatment of adenocarcinoma of the body and tail of pancreas. It usually refers to negative resection margin and dissection of re- gional lymph nodes. In recent reports, the definition of R0 mar- gin has been updated, and radical antegrade modular pancreato- splenectomy （RAMPS）, which was first described by Strasberg et al, contributes to achieving negative tangential margins. In some cases, extended radical resections were adopted in an at- tempt to achieve R0 margin. However, it would increase opera- tion related morbidity and mortality, which should be taken into account before the procedure. Lymph nodes metastasis is an im- portant prognostic factor. Extended lymph nodes dissection does not seem to bring survival benefits, while it~ helpful in assessing the tumor stages and patients＂ prognosis. Laparoscopie distal pancreatectomy （LDP） has been applied in the treatment of ductal adenocarcinoma of the pancreas in reports with small sam- ple sizes. But it remains controversial whether LDP is superior comparing to conventional open methods in regards to oncological outcomes. Curently, surgery is the promising method that may cure adenocarcinoma of the body and tail of pancreas. Highlight- ing radical resection will bring more survival benefits to patients.
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2016年第3期213-216,共4页
Chinese Journal of Hepatobiliary Surgery
关键词
胰体尾癌
根治性手术
腹腔镜
Adenocarcinoma of the body and tail of pancreas
Radical surgery
Laparoscopy
