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目的探讨直肠癌肝转移的手术时机选择、治疗方法及预后。方法以2004年1月至2006年1月期间本院收治的42例直肠癌肝转移的患者为研究对象,合理选择手术时机选择及治疗方法,随访并观察5年,观察其并发症发生率、5年生存率,评价治疗效果及预后。结果 42例患者中给予同期切除18例,分期切除24例,分期切除的患者中13例给予肝动脉结扎加无水乙醇注射治疗,11例在肝动脉结扎加化学药物灌注化疗后给予二期手术切除;手术方式的选择:29例患者给予肝不规则切除,5例患者给予右半肝切除,8例给予左半肝切除;患者的术后1、3、5年存活率分别为90.47%(38/42)、52.38%(22/42)、35.71%(15/42),平均生存期为35.78月。结论直肠癌发生肝转移后死亡率较高,生存率低,严格掌握手术的适应证,正确选择手术时机,采用正确的手术方式和治疗措施,可有效提高患者的生存率,降低死亡率。
Objective To explore the timing of operation, treatment and prognosis of liver metastasis of rectal cancer. Methods Forty-two patients with liver metastases from rectal cancer who were treated in our hospital from January 2004 to January 2006 were selected as the study objects. The timing and selection of operation were reasonably selected. The patients were followed up and observed for 5 years. The incidence of complications, 5-year survival rate, evaluation of treatment and prognosis. Results Of the 42 patients, 18 cases were resected in the same period, 24 cases were staged resection, 13 cases were treated by hepatic artery ligation and absolute alcohol injection in 11 patients undergoing staged resection, and 11 cases were treated with hepatic artery ligation plus chemical drug infusion chemotherapy Surgical options were as follows: 29 patients underwent hepatectomy, 5 patients underwent right hepatectomy and 8 patients underwent left hepatectomy. The survival rates at 1, 3 and 5 years after operation were 90.47% ( 38/42), 52.38% (22/42) and 35.71% (15/42) respectively. The average survival time was 35.78 months. Conclusion The mortality rate of rectal cancer after liver metastasis is high and the survival rate is low. Strict indications of operation indications, the correct choice of timing of surgery, correct operation methods and treatment measures can effectively improve the survival rate of patients and reduce the mortality rate.