摘要
目的探讨同时性结直肠癌肝转移行同期切除原发瘤和肝转移瘤的安全性和有效性。方法回顾性总结分析从1981年5月至2005年11月在我院住院治疗的43例结直肠癌同时性肝转移同期手术的临床病理资料及结果并结合文献复习。结果 43例患者中男性21例,女性22例,中位年龄52岁,手术持续中位时间180 min。共30例术中输血,中位输血量800 ml。术后总住院时间10～50 d,中位时间15 d。并发症发生率18.6%(8/43),手术死亡率2.3%(1/43)。全组总的中位生存期为25个月,5年生存率19.1%。R0切除组的中位生存期48个月,5年生存率33.8%;非 R0切除组的中位生存期为20个月,5年生存率7.6%。两组的生存时间经 Log Rank 检验差异明显,P=0.002。结论同时性结直肠癌肝转移同期手术的安全性和有效性可以保证。对可切除的同时性结直肠癌肝转移应争取同期手术,并争取 R0切除。
Objective To investigate the safety and long term outcome of simultaneous liver and colorectal resection for synchronous colorectal liver metastasis. Methods Forty-three synchronous colorectal liver metastasis patients who received simultaneous colectomy and hepatectomy between May 1981 and November 2005 were analyzed retrospectively. Results The group included 21 male patients and 22 female patients, with the median age of 52 years. The overall median operative time was 180 minutes, 30 cases received blood transfusion, and the median volume was 800 ml. The median hospital stay was 15 days. The morbidity and mortality was 18. 6% and 2. 3%, respectively. The overall median survival time was 25 months,5-year survival rate was 19. 1%. The survival of patients underwent R0 resection were substantially better （ median survival time 48 months, 5-year survival rate 33. 8% ） than that of the patients who did not undergo R0 resection（20 months,7. 6% ） （P =0. 002）. Conclusions Simultaneous liver and colorectal resection is safe and effective for synchronous colorectal liver metastasis. Furthermore, simultaneous R0 resection should be the optimal surgery for the resectable cases.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2007年第13期902-904,共3页
Chinese Journal of Surgery
关键词
结直肠肿瘤
肝肿瘤
继发性
肿瘤转移
Colorectal neoplasms
Liver neoplasms,secondary
Neoplasm metastasis
