A matched-pair analysis of laparoscopic versus open pancreaticoduodenectomy: oncological outcomes using Leeds Pathology Protocol
A matched-pair analysis of laparoscopic versus open pancreaticoduodenectomy: oncological outcomes using Leeds Pathology Protocol
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DOI：
10.1016/s1499-3872(14)60048-5
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发表时间：
2014-08-15
影响因子：
3.3
通讯作者：
Menon, Krishna V.
中科院分区：
文献类型：
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作者：
Hakeem, Abdul R.;Verbeke, Caroline S.;Menon, Krishna V.
背景：腹腔镜胰腺癌切除术（LPD）是一种安全的手术。LPD的肿瘤安全性仍然是一个有争议的问题。本研究的目的是比较肿瘤的结果，充分的切除和复发率LPD和开放性胰腺癌切除术（OPD）。方法：2005年11月至2009年4月，12 LPD（9壶腹和3远端胆总管肿瘤）进行。一组12例OPD患者的年龄、性别、体重指数（BMI）、美国麻醉医师协会（阿萨）评分和肿瘤部位相匹配。结果：平均肿瘤大小LPD vs OPD（19.8 vs 19.2 mm，P=0.870）。9例LPD与8例OPD实现RO切除（P=1.000）。LPD与OPD的平均转移淋巴结数和切除总数分别为1.1与2.1（P=0.140）和20.7与18.5（P=0.534）。Clavien并发症I/II级（5 vs 8）、III/IV级（2 vs 6）和胰漏（2 vs 1）在统计学上不显著（LPD vs OPD）。门诊平均高依赖单位（HDU）住院时间较长（3.7 vs 1.4天，P
BACKGROUND: Laparoscopic pancreaticoduodenectomy (LPD) is a safe procedure. Oncological safety of LPD is still a matter for debate. This study aimed to compare the oncological outcomes, in terms of adequacy of resection and recurrence rate following LPD and open pancreaticoduodenectomy (OPD).METHODS: Between November 2005 and April 2009, 12 LPDs (9 ampullary and 3 distal common bile duct tumors) were performed. A cohort of 12 OPDs were matched for age, gender, body mass index (BMI) and American Society of Anesthesiologists (ASA) score and tumor site.RESULTS: Mean tumor size LPD vs OPD (19.8 vs 19.2 mm, P=0.870). RO resection was achieved in 9 LPD vs 8 OPD (P=1.000). The mean number of metastatic lymph nodes and total number resected for LPD vs OPD were 1.1 vs 2.1 (P=0.140) and 20.7 vs 18.5 (P=0.534) respectively. Clavien complications grade I/II (5 vs 8), III/IV (2 vs 6) and pancreatic leak (2 vs 1) were statistically not significant (LPD vs OPD). The mean high dependency unit (HDU) stay was longer in OPD (3.7 vs 1.4 days, P