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
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
Externí odkaz: