对局部晚期结直肠癌患者行联合脏器切除术的临床价值

目的探讨对局部晚期结直肠癌患者行联合受累脏器整块切除的临床价值。方法回顾分析182例局部晚期结直肠癌患者的临床资料。将97例行联合脏器切除治疗患者的疗效与同期85例未行联合脏器切除治疗者进行对比分析。结果97例患者切除的相关脏器为165个,经病理组织学证实51例(52.6%)的50个相关脏器(30.3%)有癌浸润,另外46例(47.4%)的115个(69.7%)相关脏器为炎性浸润,受累脏器以小肠最为常见,占28.9%(28/97)。经联合脏器切除后,97例患者1、3、5年生存率分别为83.5%、67.1%和49.4%;而同期85例仅行肿瘤局部切除或姑息切除治疗者1、3、5年生存率分别为81.1%,58.8%和10.5%。结论对于局部晚期的结直肠癌患者,积极施行周围联合脏器切除术,是提高5年生存率的一项重要措施。

Clinical value of multivisceral resection for locally advanced colorectal cancer

Objective To investigate the clinical value of multivisceral resection for locally advanced colorectal cancer. Methods Clinical data of 182 patients with local advanced colorectal cancer during the last decade in our hospital were analyzed retrospectively. Results Ninety seven patients underwent multivisceral resection, while 85 just local resection. Postoperative pathology revealed tumor infiltration in 50 organs of 51 patients, and inflammatory adhesion in 115 organs of 46 patients. Tumor infiltration of intestine was most common (28.9%). The 1 ,2 ,3 year survival rates were 84%,67%and 49%in multivisceral resection group, compared with 81.1%,58.8%and 10.5%in local resection group. Conclusion En bloc resection of surrounding organs and structures should be performed in local advanced colorectal cancer, and multivisceral resection is safe and can improve the prognosis.