摘要目的 分析评估纳米刀治疗局部进展期胰腺癌的围手术期效果及安全性.方法 回顾性分析2015年7月至2016年1月经术前影像及手术病理证实的20例纳米刀治疗局部进展期胰腺癌患者的临床资料,通过观察分析围手术期相关并发症发生率,评估纳米刀消融胰腺癌的安全性;通过随访观察术后CT/MRI、CA19-9以及患者临床症状缓解率评估其有效性.结果 所有患者均顺利完成纳米刀消融,肿瘤平均大小(4.2 ±0.6)cm,平均消融时间(52.0±23.3) min.术中发生纳米刀相关性并发症3例(15.0％),包括一过性高血压和一过性室上性心动过速.术后发生A级胰漏2例,切口感染1例,门静脉血栓形成1例,消化道出血1例,胃肠道排空障碍1例.术后患者症状有效缓解率为73.7％,出院时血液CA19-9均有不同程度下降.结论 纳米刀治疗局部进展期胰腺癌安全有效.合理制定纳米刀手术策略有助于进一步巩固其安全性和有效性.

abstractsObjective To evaluate the perioperative safety and effect of irreversible electroporation (IRE) in the treatment of locally advanced pancreatic carcinoma (LAPC).Methods Twenty patients with imaging and cytohystological diagnosis of unresectable locally advanced pancreatic carcinoma were enrolled to undergo IRE treatment.The perioperative IRE-related complications were primarily analyzed to evaluate the safety of the procedure.The tumor reduction and biological response were analyzed through CT/MRI imaging and serous level of CA19-9.Results All patients were successfully treated with an average tumor size of(4.2 ± 0.6) cm and an average procedure time of (52.0 ± 23.3) minutes.Three intraoperative procedure-related complications were observed (15.0％) including two transient hypertension and one transient superventricular tachycardia.Six postoperative complications were described including two Grade A pancreatic fistula,one infection of incision,one portal vein thrombosis,one gastrointestinal hemorrhage and two functional delayed gastric emptying.The symptom remission rate was 73.7％ and lower serum CA19-9 level was recorded in all patients at discharge.Conclusions IRE is a safe and feasible procedure in the treatment of LAPC, and a reasonable operation strategy of IRE is helpful to consolidate the safety and efficacy.