32例结直肠癌肝转移的外科治疗

报告３２例结直肠癌肝转移的手术切除效果，其中肝脏有１－３个转移灶者２４例。在２０例为同时性肝转移癌中，转移灶与原发灶行一期切除者１５例，分期（２－４周后）切除者５例，５例为结肠直曲癌局部润转移，与原发灶整块切除，其它手术方式有不规则肝部分切除、肝左外叶切除、肝右后叶切除、肝右叶切除及肝右３叶切除等。全部病例均经病理证实，无手术死亡。３年、５年生存率分别为３７．５％、２５．０％。作者认为肝转移灶数目

RESECTION OF COLORECTAL CARCINOMA WITH METASTASIS TO THE LIVER IN 32 PATIENTS

We evaluated the surgical results in 32 patients with liver metastasis from colorectal carcinoma. Twenty four patients had 1-3 metastatic hepatic nodules and 20 patients had synchronous hepatic metastasis. Liver resection was carried out simultaneously with radical resection of the primary tumour in 15 patients, 5 patients experienced resection 2 to 4 weeks later. Liver and primary tumour were resected as a whole in 5 patients with infiltrating metastasis from colonic carcinoma.Other operative types included atypical resections, left lateral lobectom and right posterior lobectomy, and right hemihepatactomy, right trilobectomy.Hepatic metastasis were all documented by pathology. The 3 year and 5 year survival rate were 37.5% and 25.0%, with no operative death. The authors believed that the number of metastasis is the most important factor influencing the surgical result, and liver resection is an effective form of treatment for patients with resectable liver metastasis from colorectal carcinoma, but the type of surgery shall be choosed reasonably.