Pancreas-sparing duodenectomy with regional lymph node dissection for early-stage ampullary carcinoma: A case control study using propensity scoring methods
Autor: | Yong-Jiu Zhang, Wan-Yee Lau, Zhi-Qiang Wang, Bin Liu, Jing Li, Lu-Nan Yan, Sheng-Yi You, Shi-Yan Yan, Hao-Ran Sun |
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Rok vydání: | 2015 |
Předmět: |
Male
Time Factors Biopsy medicine.medical_treatment Kaplan-Meier Estimate Risk Factors Stage (cooking) Duodenoscopy Digestive System Surgical Procedures integumentary system medicine.diagnostic_test musculoskeletal neural and ocular physiology Gastroenterology Ampulla of Vater General Medicine Middle Aged Pancreaticoduodenectomy Treatment Outcome medicine.anatomical_structure Pancreatic fistula Lymphatic Metastasis Female psychological phenomena and processes Adult medicine.medical_specialty Common Bile Duct Neoplasms Urology Disease-Free Survival Pancreatic Fistula Duodenectomy mental disorders medicine Carcinoma Humans Propensity Score Aged Neoplasm Staging Retrospective Studies business.industry Retrospective cohort study Case Control Study Length of Stay medicine.disease Surgery nervous system Lymph Node Excision business Organ Sparing Treatments |
Zdroj: | World Journal of Gastroenterology. 21:5488 |
ISSN: | 1007-9327 |
Popis: | AIM: To investigate the outcomes of pancreas-sparing duodenectomy (PSD) with regional lymph node dissection vs pancreaticoduodenectomy (PD). METHODS: Between August 2001 and June 2014, 228 patients with early-stage ampullary carcinoma (Amp Ca) underwent surgical treatment (PD, n = 159; PSD with regional lymph node dissection, n = 69). The patients were divided into two groups: the PD group and the PSD group. Propensity scoring methods were used to select patients with similar disease statuses. A total of 138 matched cases, with 69 patients in each group, were included in the final analysis. RESULTS: The median operative time was shorter among the patients in the PSD group (435 min) compared with those in the PD group (481 min, P = 0.048). The median blood loss in the PSD group was significantly less than that in the PD group. The median length of hospital stay was shorter for patients in the PSD group vs the PD group. The incidence of pancreatic fistula was higher among patients in the PD group vs the PSD group. The 1-, 3-, and 5-year overall survival and disease-free survival rates for patients in the PSD group were 83%, 70%, 44% and 73%, 61%, 39%, respectively, and these values were not different than compared with those in the PD group (P = 0.625). CONCLUSION: PSD with regional lymph node dissection presents an acceptable morbidity in addition to its advantages over PD. PSD may be a safe and feasible alternative to PD in the treatment of early-stage Amp Ca. |
Databáze: | OpenAIRE |
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