Dukes D期大肠癌的手术治疗及疗效观察

目的　探讨DukesD期大肠癌手术治疗的意义及疗效。方法　对 1 991～ 1 998年间我科收治的行手术治疗的 82例DukesD期大肠癌患者进行回顾性分析。结果　 2 1例患者行联合脏器切除术 ,2 9例行姑息性切除术 ,1 9例行改道手术 ,1 3例行剖腹探查活检术。行联合脏器切除术后患者生存期明显延长 ,71 .4%生活质量为优、2 3 .8%为良、4 .8%为中 ,明显优于其它三种术式 (P<0 .0 1 ) ;行姑息性切除术后患者生活质量为优者占 62 .1 % ,良为 1 7.2 % ,中为1 3 .8% ,差为 6 .9% ,优于改道手术及剖腹探查活检术 (P<0 .0 5) ;行改道手术及剖腹探查活检术后疗效较差 ,生存期短 ,生活质量评估多为差或中。结论　DukesD期大肠癌有手术指征者经手术治疗可延长患者生命及改善生活质量

Surgical Treatment of Dukes D Stage Colorectal Carcinoma and Its Effectiveness

Objective To evaluate the significance and effect for surgery of Dukes D stage colorectal carcinoma. Methods Eighty two cases of Dukes D stage colorectal carcinoma who underwent surgery from 1991 to 1998 were analyzed retrospectively. Results Twenty one patients experienced extended resections,29 patients palliative resection, 19 patients side side anastomosis and 13 patients laparotomy and biopsy of the tumor. Patients with extended resections had significantly long survival time, quality of life in these patients were excellent in 71.4%, good in 23.8%, and fair in 4.8% ; whereas quality of life in the group with palliative resections were excellent in 62.1%, good in 17.2%, fair in 13.8% , and poor in 6.9%. The other two groups had a bad postoperative effect, short survival time and poor quality of life. Conclusion If the patients with Dukes D stage colorectal carcinoma have operative indications,surgical therapy should be actively performed and the postoperative survival rate and quality of life can be improved.