[Methods of treatment on different clinical stages in pancreatic cancer].
Pancreatic cancer is a great surgical problem. Clinical observations confirm 10-15% level of R0 resection ability. Dissatisfying treatment effects results from: lach of simple screening tests, low specificity of methods used to diagnose less than 2 cm lesions, low availability of advanced diagnostic methods (endoscopic ultrasonography), anatomy of pancreatoduodenic area, ability of infiltration adhering structures and causing metastatic tumors.


OBJECTIVE
Retrospective evaluation of treatment methods administered to patients with pancreatic cancer according to different clinical stages.


METHODS
Medical documentation of 97 patients treated during 2001-2006 period for pancreatic cancer was analyzed. The age of patients was 42-90 years (medium 66.04, SD 10.27). There were 47 women (48.45% of group) aged 43-90 (medium 67.89, SD 9.93) and 50 men (51.55%) aged 42-86 (medium 64.31, SD 10.64).


RESULTS
In analyzed group 87 tumors were located in the head of pancreas, 5 in the corpus and 5 in the cauda. In 13 cases (13.40%) partial resection of pancreas was performed. By passing anastomoses were applied in 45 cases: 26 (26.80% of total group) biliar and gastrointestinal, 19 (19.59%) only biliar anastomoses. Thoracovideoscopic splanchnicectomy was performed 26 times (26.80%) as a method of decreasing pain. 6 patients were treated with bile ducts drainage: endoscopic (4) or percutaneous (2). In 7 cases operations were limited to explorative laparotomy. Complication occurred in 5 (38.46%) cases following resection of the pancreas and 13 cases (15.38%) following paliative operations. Perioperative mortality accomplished 15.38% following pancreatic resection and 4.44% in remaining cases.


CONCLUSIONS
Pancreatic cancer is a neoplasm connected with unsuccessfull course. In most of cases diagnose is confirmed in clinical stage that disables resection with the aim of curation. Although huge progress in diagnostic methods, operational technique and perioperative care postoperative mortality is high. Videothoracoscopic splanchnicectomy is a worth reccomending method of decreasing pain.
Uniwersytet Medyczny w Łodzi, Uniwersytecki Szpital Kliniczny nr 2 im. WAM, Klinika Chirurgii Klatki Piersiowej, Chirurgii Ogólnej i Onkologicznej. piskorz.l@gmail.com
Łukasz
Ł
Piskorz
Marian
M
Brocki
Tomasz
T
Lesiak
Leszek
L
Kutwin
Sławomir
S
Jabłonski
Edyta J
EJ
Santorek-Strumiłło
Szymon
S
Wcisło
Jacek
J
Kordiak
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000706:statistics & numerical data; D002277:Carcinoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010179:Pancreas / Q000473:pathology*; D010180:Pancreatectomy / Q000706:statistics & numerical data*; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D013156:Splenectomy / Q000706:statistics & numerical data; D016019:Survival Analysis; D020775:Thoracic Surgery, Video-Assisted / Q000706:statistics & numerical data