多原发大肠癌67例临床分析

目的　探讨多原发大肠癌发病率、病理及临床特点、诊断及治疗方法。 方法　对６７ 例多原发大肠癌患者的临床资料进行回顾性分析。 结果　６００ 例结直肠癌中，有同时多原发癌４７ 例（７８ ％ ） ，异时多原发癌２０ 例（３３ ％ ） 。多原癌伴息肉者３１ 例（４６ ％ ） ，其中１７ 例为息肉癌变（１２ ％ ） ，本组手术根治切除５４ 例，姑息切除５ 例，造口５ 例，仅探查者３ 例。术后１０ 年生存率６２ ％ ，８ 年生存率７３ ％ ，５ 年生存率６７ ％ 。 结论　利用纤结镜作术前、后检查，术中注意仔细探查，是提高本病发现率的重要手段；首次手术彻底切除癌与癌前病变是提高术后生存率的重要因素。

Multiple primary colorectal carcinoma:report of 67 cases

Objective To explore the incidence,pathologic and clinical characteristics,diagnostic and therapeutic methods of multiple primary colorectal carcinoma (MPC).Methods From 1982 up to now 67 cases with MPC were treated in our hospital,and their clinical data and follow up material were analysed retrospectively.Results Among 600 patients with colorectal carinoma,there were 67 cases (11 17%) with multiple primary carcinoma (MPC).47 (7 8%) cases were with synchronous MPC, and 20 (3 0%) with metachronous MPC.31 MPC cases (46%) were found with concomitant colorectal polyps,and 17 (12 23%) had canceration of the polyps.54 cases underwent radical resection,5 cases received palliative resection,5 cases underwent colostomy,and 3 cases just underwent exploration.The postoperative 10,8,and 5 year survival rate was 62%,73%,and 67% respectively.Conclusions To improve the diagnostic rate of MPC,perioperative colonoscopy screening and follow up,careful intraoperative exploration should be emphasized.To increase the postoperative survival,maligant and precancerous tissues should be resected radically during the first operation.