晚期直肠癌55例外科治疗体会  

Treatment of advanced rectal carcinoma:a report of 55 cases.

作　　者：杨玉波[1] 王斌[1] 潘克勤[1] 张强[1] 张亚春[2] 

机构地区：[1]吉林省肿瘤医院,长春130012 [2]辽源市中医院,136000

出　　处：《中国实用外科杂志》2001年第6期358-359,共2页Chinese Journal of Practical Surgery

摘　　要：目的　探讨晚期直肠癌的外科治疗方法。方法　回顾性分析 1994～ 1999年收治的 5 5例晚期直肠癌的临床资料。结果　均为DukesD期或肝转移病例。行Hartmann术式 11例 ,单腔乙状结肠造口术 13例 ,双腔乙状结肠造口 11例 ,横结肠造口 1例。肝转移癌切除 7例。其中直肠上动脉置管化疗 2 0例 ,肝动脉置管化疗 12例。行Hartmann术式者 3年生存率为 2 7% (3/ 11) ,肝动脉置管化疗组和直肠上动脉置管化疗组平均生存期为14个月 ,未切除或未行肝动脉置管化疗的肝转移癌及非手术治疗组平均生存期 10个月。结论　姑息性手术和乙状结肠造口术主要用于治疗晚期直肠癌 ,不能切除的原发灶或肝转移灶可选择肝动脉或直肠上动脉置管化疗。姑息性手术、乙状结肠造口术及肝动脉或直肠上动脉置管化疗可解除梗阻、缓解疼痛症状 ,并能提高生活质量 。Objective To discuss the surgical treatment of advanced rectal carcinoma.Methods Fifty-five patients with advanced rectal carcinoma from 1994 to 1999 were analyzed retrospectively.Results All cases were Dukes D stage or accompanied with hepatic metastasis.Hartmann’s operation was used in 11 cases,single lumen sigmoid colostomy in 13 cases,double lumen sigmoid colostomy in 11 cases,and transverse colostomy in 1 case.Resection of hepatic metastasis in 7 cases.Among them upper rectal arterial catheter chemotherapy was used in 20 cases and hepatic arterial catheter chemotherapy in 12 cases.The survival rate of Hartmann’s operation was 27%(3/11),the average survival spans were 14 months in upper rectal and hepatic arterial catheter chemotherapy group and 10 months in groups that could not be treated surgically.Conclusion Palliative resection and colostomy are mainly used in advanced cases while arterial catheter chemotherapy is selected in cases that primary or secondary lesions are unresectable.Palliative resection,upper rectal or hepatic arterial catheter chemotherapy and colostomy are valuable in releasing the symptoms of obstruction of colon,increasing the quality of life and prolonging survival rate.

关 键 词：晚期直肠癌 外科手术 动脉置管化疗 

分 类 号：R735.37[医药卫生—肿瘤] R730.5[医药卫生—临床医学]