张继红 陈国忠 霍枫 510010 广州军区广州总医院普通外科 中华肿瘤杂志 1999 0 21 4


    关键词：Vater壶腹癌/外科学；手术后并发症；预后 期刊 zhzlzz 0 临床应用 fur -->


    

【摘要 】 目的 探讨总结Vater壶腹癌局部切除的理论依据、复发原因、适应证、术式评价。方法 收集并分析国内1992～1997年报告的48例和我院经治的4例，共52例局部切除治疗Vater壶腹癌的临床资料。结果 52例Vater壶腹癌行局部切除术，并发症发生率9.6%，手术死亡率3.8%。随访7个月至8年，12例复发，其中7例切缘有癌组织残存；低分化腺癌3例，侵袭性腺癌1例；19例死亡(包括2例手术死亡)，余生存8个月至4年。32例无瘤健存7个月至8年，失访1例。结论 Vater壶腹癌局部切除有一定疗效，其预后与肿瘤大小、侵袭范围和程度、有无淋巴结转移、肿瘤的病理类型和分化程度有关，更与手术切除的切缘是否有癌有关。其创伤小、恢复快、手术并发症及死亡率低，局部切除对高龄、一般情况差、有严重合并症等高危因素存在的早期壶腹癌患者是一种较理想的治疗方法。

Local resection of carcinoma ofampulla of Vater: an analysis of 52 cases

ZHANG Jihong, CHEN Guozhong, HUO Feng.Department of General Surgery, General Hospital of Guangzhou Military Command, Guangzhou510010

【Abstract 】 Objective Tostudy the therapeutic results of patients with carcinoma of ampulla Vater treated by localtumor resection. Methods Four cases of carcinoma of ampulla of Vatertreated in our hospital by local tumor resection and 48 cases reported in Chinese medicalliterature in 1992～1997 were analyzed. Results A total of 52 caseswas collected who received local resection of carcinoma of ampulla of Vater. The operativemortality was 3.8% and the morbidity was 9.6%. Recurreuce occurred in 12 cases, of whom 3had poorly differentiated adenocarcinoma, 7 had their tumor incompletely resected withtumor left at the cutting edge and one had local invasion. In 8 month to 4 years, 19 casesdied. Thirty two cases survived for 7 months to 8 years after operation. Conclusion Theprognosis of local resection is related not only to tumor size, extent of invasion,metastasis to lymph node, but also to pathologic types and differentiation. It is atreatment of choice for early carcinoma of ampulla of Vater in patients who are athigh-risk due to old age, poor general condition or severe concurrentdiseases.

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