扩大淋巴结清扫对腹腔镜下肝门胆管癌根治术患者临床预后的随访研究Follow-up study on the clinical prognosis of patients undergoing laparoscopic radical resection of hilar cholangiocarcinoma with expanded lymph node dissection
周燕;刘宇;魏玲玲;李仕强;
摘要(Abstract):
目的分析扩大淋巴结清扫对腹腔镜下肝门胆管癌(hilar cholangiocarcinoma,HCC)根治术患者临床预后的随访结果。方法回顾性分析2015年3月至2018年3月陆军军医大学第二附属医院收治的104例HCC患者的临床资料,按照患者术中淋巴结清扫范围,将接受扩大淋巴结清扫的患者纳入扩大组(61例),将接受区域淋巴结清扫的患者纳入区域组(43例)。对比两组患者手术情况、术后恢复情况、术后并发症发生情况以及术后3年生存情况。结果扩大组患者淋巴结清扫数量、阳性淋巴结清扫数量均显著多于区域组(均P<0.05)。两组患者重症监护病房住院天数、总住院天数、术后并发症发生率、术后3年生存率比较差异均无统计学意义(均P>0.05)。扩大组术后3年内死亡患者中,11例(34.38%)为肝内复发;区域组术后3年内死亡患者中,9例(37.50%)为肝内复发。结论扩大淋巴结清扫能够增加腹腔镜下HCC根治术中淋巴结清扫数量和阳性淋巴结清扫数量,其术后恢复情况和并发症发生风险与区域淋巴结清扫相当,但这一术式并未对患者3年生存率带来积极影响。
关键词(KeyWords): 扩大淋巴结清扫;腹腔镜;肝门胆管癌根治术;随访
基金项目(Foundation):
作者(Authors): 周燕;刘宇;魏玲玲;李仕强;
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