Short-term and long-term clinical outcomes of combined major vessel resection for hilar cholangiocarcinoma: a propensity score analysis.
Short-term and long-term clinical outcomes of combined major vessel resection for hilar cholangiocarcinoma: a propensity score analysis.
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肺胆管癌的主要血管切除术的短期和长期临床结果：倾向评分分析。
DOI：
10.4174/astr.2023.105.5.319
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发表时间：
2023-11
影响因子：
1.4
通讯作者：
Lu J
中科院分区：
文献类型：
--
作者：
Wang Y;Lu J
在肝门部胆管癌（HCCA）的治疗中，联合切除肝内重要血管仍有争议。本研究的目的是比较联合和非联合大血管切除术在HCCA根治性切除患者中的术后并发症和预后。在这项研究中，回顾性入组了2007年1月至2018年12月期间接受根治性切除术的HCCA患者。采用倾向评分匹配（PSM）分析比较两组术后并发症和预后。本研究纳入了310例患者。门静脉切除（PVR）和肝动脉切除（HAR）组术后并发症发生率高于对照组。HAR组患者术后腹腔和胸腔积液的风险增加。接受联合PVR的患者具有更好的总生存期（OS; P = 0.020）和无病生存期（DFS; P = 0.020）。根治性切除后，HAR组患者的OS（P = 0.027）和DFS（P = 0.023）均有所改善。联合血管切除术（VR）的术后并发症并没有恶化患者的长期生存。在HCCA患者中，联合VR改善了预后。联合VR的术后并发症不会使患者生存率恶化。因此，建议根治性手术切除。
In the treatment of hilar cholangiocarcinoma (HCCA), combined resection of important hepatic vessels remains controversial. The purpose of this study was to compare the postoperative complications and prognosis of combined and non-combined major vessel resections in patients undergoing radical resection for HCCA. In this study, patients with HCCA who underwent curative resection between January 2007 and December 2018 were retrospectively enrolled. Postoperative complications and prognosis between the groups were compared using propensity score-matching (PSM) analysis. There were 310 patients included in this study. The portal vein resection (PVR) and hepatic artery resection (HAR) groups had a higher incidence of postoperative complications than the control group. Patients in the HAR group had an increased risk of abdominal and pleural effusion after surgery. Patients who underwent combined PVR had better overall survival (OS; P = 0.020) and disease-free survival (DFS; P = 0.020). After curative-intent resection, patients in the HAR group had improved OS (P = 0.027) and DFS (P = 0.023). The postoperative complications of combined vascular resection (VR) did not worsen long-term survival for patients. In patients with HCCA, combined VR improved prognosis. The postoperative complications of combined VR do not worsen patient survival. Therefore, radical surgical resection is recommended.
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影响因子：
13.8
作者：
Wu, Yibin;Mao, Anrong;Wang, Huipeng;Fang, Guojiu;Zhou, Jiamin;He, Xigan;Cai, Sanjun;Wang, Lu
通讯作者：
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影响因子：
3
作者：
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影响因子：
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作者：
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