结直肠癌并肝转移的手术治疗

目的：探讨结直肠癌肝转移的手术切除效果。方法：回顾分析结直肠癌并肝转移32例的临床资料，着重手术切除效果的分析。结果：32例结直肠癌肝转移患者中肝脏有1-3个转移灶者24例，在20例为同时性肝转移癌中，转移性与原发灶行一期切除者15例，分期（2-4周后）切除者5例。5例为结肠肝曲癌局部浸润转移。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。全部病例均病理检查证实，无手术死亡，3年、5年生存率分别为37.5%和25.0%。结论：肝转移灶数目是影响疗效的主要因素。对肝转移灶手术切除是最有效的方法。但应合理选择具体手术方式。

The Surgical Treatment of Colorectal Carcinoma with Hepatic Metastasis

Objective: To investigate the therapeutic effect of hepatic carcinoma metastasized from colorectal carcinoma treated by surgery. Methods: The clinical data of 32 patients with hepatic metastasis from colorectal carcinoma were retrospectively analyzed with emphasis on surgical effects. Results: Twenty-four patients had one to three metastatic hepatic nodules. Among 20 patients with synchronous hepatic metastasis, resection of the hepatic metastasis was carried out simultaneously with radical resection of the primary tumor in 15 patients; the hepatic metastasis were resected by stages two to four weeks later in 5 patients.About operation types, massive resection was carried out in 5 patients with infiltrating metastasis from colonic carcinoma in hepatic flexure. Other types included atypical resection, left lateral lobectomy, right posterior lobectomy, right hemihepatectomy and right trilobectomy. All hepatic metastasis were confirmed pathologically. The 3- year and 5-year survival rate was 37.5% and 25%, no operative death. Conclusions:The number of hepatic metastasis is the most important factor influencing surgical effect. Surgical resection is the most effective method for the treatment of resectable hepatic metastasis from colorectal carcinoma, but the operative type should be chosen reasonably.