RESUMO
Basing on analysis of own material (84 patients) and data of literature there was established, that vascular invasion by pancreatic tumors constitutes the main obstacle for conduction of the patients' radical treatment. Early diagnosis permits radical resectability of the patients, what constitutes the only one effective method of treatment. In vascular invasion by tumor a surgeon experience and professional preparation determines possibility of the extended operation performance with intervention on affected main vessel, enhancing the treatment radicalism.
Assuntos
Adenocarcinoma/diagnóstico , Carcinoma Papilar/diagnóstico , Neovascularização Patológica/diagnóstico , Pâncreas/patologia , Neoplasias Pancreáticas/diagnóstico , Adenocarcinoma/irrigação sanguínea , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/cirurgia , Idoso , Carcinoma Papilar/irrigação sanguínea , Carcinoma Papilar/diagnóstico por imagem , Carcinoma Papilar/cirurgia , Diagnóstico Precoce , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neovascularização Patológica/diagnóstico por imagem , Neovascularização Patológica/patologia , Neovascularização Patológica/cirurgia , Pâncreas/irrigação sanguínea , Pâncreas/diagnóstico por imagem , Pâncreas/cirurgia , Neoplasias Pancreáticas/irrigação sanguínea , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/cirurgia , Estudos Retrospectivos , Artéria Esplênica/diagnóstico por imagem , Artéria Esplênica/patologia , Artéria Esplênica/cirurgia , UltrassonografiaRESUMO
Basing on own material analysis (386 observations) and the literature date there was established, that hepatic resection occupies the first place in treatment of the organ focal affection, together--nontumoral and a tumoral one. The treatment of all kinds of focal hepatic affection must be expanded in a specialized clinic in the Ukraine. The main task of the investigation was to determine a permissible volume of hepatic resection, depending on functional state of the organ parenchyma, improvement of existing and elaboration of a new methods of operative intervention, directed on the complications prophylaxis and the hepatic function preservation.
Assuntos
Carcinoma Hepatocelular/cirurgia , Colangiocarcinoma/cirurgia , Hepatectomia/métodos , Insuficiência Hepática/etiologia , Neoplasias Hepáticas/cirurgia , Complicações Pós-Operatórias , Sarcoma/cirurgia , Adulto , Idoso , Carcinoma Hepatocelular/mortalidade , Carcinoma Hepatocelular/secundário , Colangiocarcinoma/mortalidade , Colangiocarcinoma/secundário , Neoplasias Colorretais/mortalidade , Neoplasias Colorretais/secundário , Neoplasias Colorretais/cirurgia , Feminino , Insuficiência Hepática/mortalidade , Insuficiência Hepática/patologia , Humanos , Fígado/patologia , Fígado/cirurgia , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/mortalidade , Neoplasias Pancreáticas/secundário , Neoplasias Pancreáticas/cirurgia , Sarcoma/mortalidade , Sarcoma/secundário , Neoplasias Gástricas/mortalidade , Neoplasias Gástricas/secundário , Neoplasias Gástricas/cirurgia , Análise de Sobrevida , UcrâniaRESUMO
Remote results of surgical treatment of patients, suffering locally spread forms of pancreatic malignancies (PM), using different approaches, were analyzed. In retrospective investigation were included 84 patients with PM and invasion of the main vessels. In the group Ð patients palliative operations were performed, including in a subgroup Ðа cryoablation of PM, in a subgroup Ðb palliative pancreatic resection with leaving the tumor on the main vessels intact; and in patients of group ÐÐ the tumor was resected radically, including in a sub* group ÐÐаpancreatic resection or total pancreatectomy with resection of the main vessels, and in subgroup ÐÐb pancreatic resection or total pancreatectomy with cryoablation of tumor, which was left on the main vessel. The oneyear, threeyears and fiveyears survival indices have constituted in a subgroup Ðа, accordingly 74, 17 and 0% (survival median 16 mo); in a subgroup Ðb 70, 20 and 0% (survival median 20 mo); in a subgroup ÐÐа 83, 49 and 21% (survival median 29 mo); in a subgroup ÐÐb 73, 41 and 18% (survival median 26 mo). Difference between the general survival indices in subgroups Ðа and ÐÐа, Ðb and ÐÐа is statistically significant. Application of aggressive surgical tactics have permitted to improve the general survival indices of the patients.