摘要
目的 探讨局部晚期大肠癌联合脏器切除术的可行性、意义及手术方法。方法 1982年以来对局部晚期大肠癌施行多脏器联合切除术 66例 ,分别联合切除其它 1～ 7个脏器 ,59例获根治性切除。对该组的治疗方法、病理类型、手术并发症、术后复发情况和生存率进行回顾性分析。结果 全组发生并发症 8例( 12 .1% ) ,无手术死亡。根治术后的 1、3、5年生存率分别为 10 0 .0 %、70 .9%、4 8.9%。结论 对局部晚期大肠癌行扩大的联合脏器切除术是安全可行和有意义的。力争根治性整块切除 ,行扩大的区域淋巴结清扫 ,注意并发症防治 ,应用动脉灌注和腹腔化疗等有助于降低并发症 。
Objective :Toinvestigatethefeasibility ,significanceandoperativemethodsofthecombinedmultiviscer alresectionforthelocallyadvancedcolorectalcarcinoma .Methods :66casesofpatientswithlocallyadvancedcolorectal cancerhaveundergonecombinedmultivisceralresectionsince 1982 .Outofthem 59casesunderwentradicalresection . Thenumberofresectedsurroundingorgansvariedfrom 1to 7foreachpatient.Themethodsoftreatment,pathological typesoftumor ,theoperativecomplications ,recurrentlocusofdiseaseandthesurvivalratesareretrospectivelyanalyzed . Results :Thetotalpostoperativecomplicationsmorbiditywas 12 .1%andmortalityrate 0 % .The 1,3,5-yearsurvival ratwererespectively 10 0 .0 % ,70 .9%and 4 8.9%intheradicalsurgerycases .Conclusion :Themultivisceralresection shouldbesafe ,feasibleandbeneficialforpatientswithlocallyadvancedcolorectalcancer.Tostriveforradicalenbloc resectionwithextendedlymphadenectomy ,topayattentiontopreventingandtreatingcomplications ,andtoemploythe intra -arterialandintraperitonealchemotherapymighthelptodecreasethecomplicationsandincreasethesurvival.
关键词
大肠癌
扩大切除术
联合脏器切除
治疗
colorectal carcinoma
locally advanced stage
multivisceral resection
extended resection
