局部进展期大肠癌的联合脏器切除术  

Extended resections of locally advanced colorectal carcinoma .

作　　者：何建军[1] 杨毅军[1] 陈武科[1] 常东民 石景森[1] 喻德洪[2] 

机构地区：[1]西安医科大学第一附属医院肿瘤外科,710061 [2]第二军医大学附属长海医院,上海200433

出　　处：《中国实用外科杂志》1999年第9期551-552,共2页Chinese Journal of Practical Surgery

摘　　要：目的　研究局部进展期大肠癌扩大切除术的安全性，评价疗效和适用范围。方法　回顾性研究了１９７８ ～１９９３ 年行联合脏器切除的局部进展期（ Ⅳ期－ 中国改良法分类） 大肠癌６５ 例，选择同时期非联合脏器切除的６５ 例Ⅲ期病例作配对研究，比较两组手术并发症、手术死亡率、肿瘤复发率、术后生存率。并分析联合脏器切除组内疗效与年龄、性别、病变位置、病理特征、淋巴结转移范围、是否放化疗的关系。结果　两组病例在手术并发症和死亡率方面差异无显著性，５ 年生存率Ⅳ期病例与Ⅲ期相比差异无显著性意义。联合脏器切除术疗效与肿瘤病理特征、淋巴结转移范围关系密切。结论　对局部进展期大肠癌行联合脏器切除术是安全可行的，对提高病人生存率有肯定作用。对分化高的病例行此手术确保肿瘤完整切除尤为必要。Objective To assess the morbidities and mortalities ofthe extended resections oflocally advanced colorec tal carcinoma ,and to evaluate its effects . Methods Sixty - five patients with locally advanced colorectal cancer( StageⅣ, Chinese Reformed Classification)underwent extended resectionsin our hospital during 1978 ～1993 . The matched -pairstudy was performed between the above cases and other 65 cases selected from patients as stage Ⅲin the sametime . Besides ,in extended resection group ,severalfactors that probably correlated with the effects were estimated . Re sults There were no significant differencesin morbidity and mortality between two groups . Five - year survival rate ofextended resection group( Stage Ⅳ)and nonextended resection group( Stage Ⅲ)was 52 % (34/65) ,and 62 % (40/65)re spectively . There was no significant difference between the two groups. In extended resection group ,the prognosis deci sively correlates with pathologicalcharacteristic andlymph nodalstage. Conclusion Extended radicalresection is safeinpatients with locally advanced colorectalcancer. It has definite effectto improve the survivalrate . In patient with well-differentiated carcinoma ,it’s necessary and important to ensure en bloc resection using this operation .

关 键 词：大肠癌 局部进展期 扩大切除术 

分 类 号：R735.340.5[医药卫生—肿瘤]