摘要
目的 探讨手术切除联合同期射频消融(RFA)治疗结直肠癌肝转移的临床疗效。方法 回顾性分析我院2016年1月至2020年12月收治的58例结直肠癌肝转移患者的临床资料。观察组患者26例,行结直肠癌根治术及肝转移癌RFA。对照组患者32例,行结直肠癌根治术及肝转移癌切除术。比较两组患者手术相关指标(手术时间、术中出血量、肛门首次排气时间、住院时间)、术后并发症(切口感染、吻合口漏、粘连性肠梗阻、胆漏、吻合口出血)、术后复发率及生存率。两组患者术后均随访3年。结果 观察组手术时间及术中出血量分别为(220.15±41.43)min和(270.76±40.04)ml,对照组分别为(270.63±30.32)min和(354.29±84.35)ml,两组间比较差异有统计学意义(P<0.001);术后并发症中观察组胆漏发生率为(0),低于对照组(18.75%),差异有统计学意义(P<0.01);两组患者术后1、2、3年的生存率及无瘤生存率差异均无统计学意义(P>0.05)。结论 结直肠癌肝转移同期手术联合RFA治疗是安全有效的,对不可耐受手术切除及位置深在的转移癌可局部毁损,降低出血及漏胆等并发症而提高患者生存质量,可推广应用。
Objective To investigate the clinical efficacy of surgical resection combined with concurrent radiofrequency ablation(RFA)in the treatment of colorectal cancer with liver metastasis.Methods A retrospective analysis was conducted on clinical data of 58 patients with CRLM admitted to our hospital from January 2016 to December 2020.26 patients in the observation group underwent radical resection for colorectal cancer and RFA for liver metastases.32 patients in the control group underwent radical resection of colorectal cancer and resection of liver metastases.Compare the surgical related indicators(surgery time,intraoperative blood loss,first anal exhaust time,hospital stay),postoperative complications(incision infection,anastomotic leakage,adhesive intestinal obstruction,bile leakage,anastomotic bleeding),postoperative recurrence rate,and survival rate between two groups of patients.Both groups of patients were followed up for 3 years after surgery.Results The surgical time and intraoperative blood loss in the observation group were(220.15±41.43)min and(270.76±40.04)ml,respectively,while those in the control group were(270.63±30.32)min and(354.29±84.35)ml,respectively.The difference between the two groups was statistically significant(P<0.001);The incidence of bile leakage in the observation group of postoperative complications was(0),lower than that in the control group(18.75%),and the difference was statistically significant(P<0.01);There was no statistically significant difference in the survival rate and tumor free survival rate between the two groups of patients at 1,2,and 3 years after surgery(P>0.05).Conclusion The combination of CRLM surgery and RFA treatment is safe and effective.It can locally destroy and reduce complications such as bleeding and bile leakage in patients with intolerable surgical resection and deep-seated metastatic cancer,and improve their quality of life.It can be widely applied.
作者
张国平
敬敏
张航
苏星
Zhang Guoping;Jing Min;Zhang Hang(Department of Hepatobiliary Surgery,Department of Pathology,Neijiang First People's Hospital,Neijiang,Sichuan 641000,China)
出处
《四川医学》
2025年第8期904-908,共5页
Sichuan Medical Journal
关键词
结直肠癌
肝转移
同期手术
射频消融
colorectal cancer
liver metastasis
simultaneous surgery
RFA
