共查询到19条相似文献,搜索用时 171 毫秒
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胰腺癌是全世界范围内发病率和死亡率不断上升的致命恶性肿瘤。胰头是胰腺癌发生的主要部位,由于其解剖位置特殊,早期症状常不明显,发现时多属晚期,预后极差。目前,外科手术可能是胰头癌有限的治疗方法中唯一有效的治愈方法,患者的术后远期疗效也随着外科技术及手术方式的不断发展在一定程度上得以提高。手术方式的选择由最初的标准切除术逐步演变为更加接近根治性切除的扩大根治术,包括联合血管切除、扩大淋巴结清扫及联合脏器的切除,但其治疗效果在某些方面仍存在诸多争议。 相似文献
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胰腺癌手术治疗进展 总被引:1,自引:0,他引:1
胰腺切除已成为一种挽救胰腺癌病人的治疗手段 ,随着近年来外科技术日臻成熟 ,某些高难度手术不断得以发展。现在 ,胰瘘等严重并发症逐渐减少 ,患者术后生活质量也有进一步改善。1 胰头癌手术胰腺癌可发生于胰腺的任何部位 ,但以胰头部最多见 (占 65%~ 75% )。其手术切除方式常采用胰十二指肠切除术 (Whipple procedure) ,该术式进展主要集中在如何减少胰瘘等并发症和扩大切除术以提高根治率。1 .1 胰腺断端和胃肠道吻合重建胰肠吻合有胰腺空肠端侧吻合和端端吻合两种。无论何种吻合 ,胰管内置入支撑管 ,另一端置入肠腔 ,此术式被公认为… 相似文献
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胰腺癌恶性程度高,进展迅速,是消化系统常见的恶性肿瘤,相对于其他实体肿瘤的治疗,胰腺癌治疗效果令人失望,5年总生存率低于5%。手术切除是唯一可能治愈胰腺癌的手段。Cameron等回顾性分析了405例胰头癌胰十二指肠切除术,术后5年的生存率可达18%。但胰腺癌起病隐匿,早期发现困难,易发生转移,明确诊断的胰腺癌病人可行根治性手术者仅占10%-20%,大部分患者因远处转移或血管浸润而无法手术切除。目前,对晚期不可切除胰腺癌病人主要采用放疗、 相似文献
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彭宝岗 《消化肿瘤杂志(电子版)》2008,1(2)
胰腺癌是发生于胰腺的恶性肿瘤,70%以上发生于胰头部,其余发生于体尾部或者全胰.组织学上,导管腺癌占大多数.胰腺癌转移和扩散途径以淋巴结转移及局部浸润最为多见,就诊时常有淋巴结转移.近年来发病率有上升的趋势,在美国,胰腺癌已占据恶性肿瘤病死率的第四位.胰腺癌最有效的治疗手段是手术切除,胰头癌常施行胰十二指肠切除术,体尾癌常施行胰体尾联合其它脏器切除,弥漫型可行全胰切除术.胰腺癌早期症状不典型,恶性程度高,发现时常属晚期.据中国抗癌协会胰腺癌专业委员会资料1,Ⅲ期和Ⅳ期患者占81.6%.胰腺癌手术切除率低(约20%),并发症多,5年生存率低(约5%以下). 相似文献
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于新宝 《国外医学(肿瘤学分册)》1991,(2)
治愈胰腺癌唯一可能的方法是手术切除。然而在70岁及70岁以上患者中用根治性胰切除术治疗胰腺癌却颇有争议。作者复习近5年胰切除术治疗各种肿瘤的病例,旨在研究70岁及70岁以上患者围手术期的发病率和死亡率。 1982~1987年间活检证实的206例原发性 相似文献
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胰腺癌是发生在胰腺外分泌组织的一种常见的恶性肿瘤。其根治性手术包括 :①胰十二指肠切除术 :适用于胰头癌。②胰体尾及脾切除术 :适用于胰体尾部癌。③全胰切除术 :适用于胰腺多发癌。胰十二指肠切除手术由于牵涉到胰管空肠吻合、胆管空肠吻合及胃空肠吻合等一系列消化道重建问题 ,因此是腹部外科最大的手术之一。术后伤口完全愈合 ,无并发症发生 ,患者即可出院。做好病员出院前的康复指导 ,可提高他们出院后的生活质量 ,因此这是健康服务的一个重要课题。 1998年至今我们对 3 8例胰腺癌根治术后患者实施了系统性的出院指导 ,收到较好效… 相似文献
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《中国医学文摘:肿瘤学》2007,21(4):303-304
VEGF反义核酸抑制人胰腺癌细胞的增殖,腹腔镜胰体尾切除手术经验,侵犯重要血管的胰头癌切除的可行性探讨,先行门-肠系膜上静脉重建的扩大胰十二指肠切除术,术中超声引导^125I放射性粒子植入治疗14例晚期胰腺癌体会,吉西他滨联合奥沙利铂治疗晚期胰腺癌的临床观察,适形放射治疗联合热疗治疗晚期胰腺癌的疗效及临床受益反应观察, 相似文献
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Although surgical resection provides the only potentially curative modality in patients with pancreatic cancer, the long-term results of pancreatectomy still remain extremely poor. Despite the recent advances made in surgical techniques and/or increased surgical radicality, only limited progress has been made in improving the survival. Moreover, pancreatic cancer in most patients is surgically unresectable at the time of diagnosis. Chemotherapy and/or radiotherapy, therefore, still remain key modalities for treatment of pancreatic cancer. Recently, several randomized trials on the effects of these modalities have been reported. Various newly designed large-scale clinical trials are now in progress. In this article, recent important insights into the surgical treatment, chemotherapy, and radiotherapy of pancreatic cancer are discussed. 相似文献
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B. M. Künzli H. Friess J. Kleeff E. Yekebas O. Mann J. R. Izbicki Prof. Dr. M. W. Büchler 《Der Onkologe》2004,10(12):1285-1300
Pancreatic cancer is still a devastating disease, which is presently the fourth or fifth leading cause of cancer-related death in Western countries with a poor prognosis even after tumor resection. Approximately 150,000 people worldwide and 40,000 people in Europe die each year of pancreatic cancer, making it one of the most aggressive human tumors. An overall 5-year survival of less than 1% is frequently reported and little has changed in recent decades. Complete resection of the entire tumor is still the only possibility to cure pancreatic carcinoma. Despite many clinical improvements, only little has changed in the long-term survival of patients with pancreatic cancer. Due to essential improvements in the field of surgery in the last decade, it is nowadays possible to resect more patients and the operative procedures have become safer in terms of morbidity and mortality. It is still a challenging task to diagnose pancreatic cancer in early tumor stages, because the disease usually becomes symptomatic at an advanced stage. Therefore, the overall resectability rate of pancreatic cancer is only 10–15%. On the other hand, low responsiveness to chemotherapy, radiotherapy, immunotherapy, and antihormonal treatment contributes to the poor prognosis. These facts together result in low resectability rates after diagnosis, early tumor recurrence after resection, and poor overall survival rates. 相似文献
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随着发病率和死亡率的增加,癌症不仅成为中国疾病致死的重要原因,也同样是困扰世界的一个重大公共卫生问题。尤其令人担忧的是,全世界每年新发胰腺癌病例数呈现逐年上升的趋势。胰腺癌患者的预后较差,其5年生存率仅约6%,其主要原因包括:①在疾病的早期缺乏典型的临床症状,早期诊断困难;②高侵袭转移特性导致难以控制的复发和转移;③缺乏有效的化疗及靶向治疗药物;④容易对现有化疗药物产生耐药。手术根治性切除仍是目前最有效的治疗方式,但是根治术后早期转移复发仍是造成手术预后不良的主要问题。本文将就2015年全球范围内针对胰腺癌发病因素、流行病学调查、基础研究热点、外科手术相关进展、内科治疗和精准医学等方面的研究及诊疗前沿进展进行回顾性分析。 相似文献
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胰十二指肠切除联合血管重建治疗胰头、十二指肠恶性肿瘤 总被引:1,自引:1,他引:1
背景与目的:胰头癌、十二指肠癌的治疗,手术切除仍是唯一可能根治的有效方法。但临床确诊时,多数为晚期,常累及门静脉/肠系膜上静脉、下腔静脉即属手术禁忌症。本研究旨在探讨累及门静彬肠系膜上静脉、下腔静脉的胰头癌、十二指肠癌切除的处理方法,以提高切除率及生存率。方法:总结2002年2月-2005年6月5例联合血管重建胰十二指肠切除术的临床资料及经验,其中胰头癌合并门静脉/肠系膜上静脉切除人工血管重建3例,十二指肠癌合并下腔静脉切除人工血管重建2例。结果:本组病例无围手术期死亡。无人工血管感染、阻塞并发症。随访10个月死亡1例,24个月死亡1例,术后存活超过3年2例,超过4年1例。结论:对累及门静彬肠系膜上静脉、下腔静脉的胰头癌、十二指肠癌行胰十二指肠切除联合血管重建手术是安全的,可提高肿瘤切除率,延长患者生存时间。 相似文献
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Pancreatic cancer is the fourth leading cause of cancer death, and it is estimated that over 43,000 people would be diagnosed with and over 36,000 people would die of pancreatic cancer in the United States in 2010. Surgical resection remains the only chance for possible cure, but only 15% to 20% of patients newly diagnosed with pancreatic cancer are considered for surgical resection. Of these, the median five-year survival rate is still less than 20%, with most resections resulting in recurrent disease. This suggests that even seemingly resectable pancreatic cancer has microscopic systemic spread before operative intervention occurs. Both adjuvant and neoadjuvant therapies have been studied in an effort to improve survival for patients with resectable pancreatic cancer. 相似文献
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