Phẫu Thuật Cắt Tuyến Tụy Xâm Lấn Tối Thiểu So Với Phẫu Thuật Cắt Tuyến Tụy Mở Đối Với Các Khối U Nội Tiết Thần Kinh Tụy: Nghiên Cứu So Sánh Theo Điểm Xu Hướng

World Journal of Surgery - Tập 44 - Trang 3043-3051 - 2020
Hwee-Leong Tan1, Roxanne Y. A. Teo1, Nicholas L. Syn2, Jin-Yao Teo1, Ser-Yee Lee1, Peng-Chung Cheow1, Pierce K. H. Chow1,3, Alexander Y. F. Chung1, London L. P. J. Ooi1,3, Chung-Yip Chan1, Brian K. P. Goh1,3
1Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore, Singapore
2Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
3Duke-National University of Singapore Medical School Singapore, Singapore, Singapore

Tóm tắt

Các khối u nội tiết thần kinh tụy (PNEN) ngày càng trở nên phổ biến với sự phát triển của các phương pháp hình ảnh hiện đại, và phẫu thuật cắt bỏ vẫn là phương pháp điều trị chính. Nghiên cứu này nhằm thực hiện một so sánh theo điểm xu hướng (PSM) về các kết quả phẫu thuật và ung thư học sau phẫu thuật cắt tụy xâm lấn tối thiểu (MIP) so với phẫu thuật cắt tụy mở (OP) cho PNEN. Một đánh giá hồi cứu đã được tiến hành trên các bệnh nhân đã trải qua phẫu thuật điều trị cho PNEN tại Bệnh viện Đa khoa Singapore từ năm 1997 đến 2018. Một PSM tỷ lệ 1:1 đã được thực hiện giữa MIP và OP, sau đó cả hai nhóm được cân bằng về các biến số cơ bản. Chúng tôi đã nghiên cứu 134 bệnh nhân đã trải qua phẫu thuật (36 MIP và 98 OP) cho PNEN. So sánh theo điểm xu hướng giữa 35 bệnh nhân MIP và 35 bệnh nhân OP cho thấy nhóm MIP có thời gian phẫu thuật dài hơn (MD = 75,0, 95% CI 15,2 đến 134,8, P = 0,015), mất máu trong phẫu thuật thấp hơn (MD = -400,0, 95% CI -630,5 đến -169,5, P = 0,001), thời gian nằm viện sau phẫu thuật ngắn hơn (MD = -1,0, 95% CI -1,9 đến -0,1, P = 0,029) và thời gian quay lại ăn uống ngắn hơn (MD = -1,0, 95% CI -1,9 đến -0,1, P = 0,039). Không có sự khác biệt giữa hai nhóm về các kết quả bất lợi ngắn hạn và sự очистка ung thư. Tỷ lệ sống sót tổng thể (HR = 0,84, 95% CI 0,28 đến 2,51, P = 0,761) và tỷ lệ sống không có bệnh (HR = 0,57, 95% CI 0,20 đến 1,64, P = 0,296) là tương đương. MIP là một phương pháp an toàn và khả thi cho PNEN và có liên quan đến mất máu trong phẫu thuật thấp hơn, thời gian nằm viện sau phẫu thuật và thời gian quay lại ăn uống ít hơn, bù lại bằng thời gian phẫu thuật dài hơn so với OP.

Từ khóa

#PNEN #phẫu thuật cắt tụy xâm lấn tối thiểu #phẫu thuật cắt tụy mở #điểm xu hướng #kết quả phẫu thuật #ung thư học

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