腹腔镜手术治疗结肠癌肝转移并盆腔转移一例  

Laparoscopic surgery for colon cancer liver metastasis and pelvic metastasis:a case report

作　　者：向俊西[1] 杨魁 王光辉 李龙[3] 张月浪[4] 吴胤英 杨威[1] 佘军军 刘青光[1] 姚英民[1] 郭成[1] Xiang Junxi;Yang Kui;Wang Guanghui;Li Long;Zhang Yuelang;Wu Yinying;Yang Wei;She Junjun;Liu Qingguang;Yao Yingmin;Guo Cheng(First Affiliated Hospital of Xi′an Jiaotong University,Department of 1Hepatobiliary Surgery,Xi′an 710061,China;First Affiliated Hospital of Xi′an Jiaotong University,Gastrointestinal Surgery,Xi′an 710061,China;First Affiliated Hospital of Xi′an Jiaotong University,Gynaecology,Xi′an 710061,China;First Affiliated Hospital of Xi′an Jiaotong University,Radiology,Xi′an 710061,China;First Affiliated Hospital of Xi′an Jiaotong University,Oncology,Xi′an 710061,China)

机构地区：[1]西安交通大学第一附属医院肝胆外科,710061 [2]西安交通大学第一附属医院胃肠外科,710061 [3]西安交通大学第一附属医院妇科,710061 [4]西安交通大学第一附属医院影像科,710061 [5]西安交通大学第一附属医院肿瘤内科,710061

出　　处：《中华腔镜外科杂志（电子版）》2021年第4期241-244,共4页Chinese Journal of Laparoscopic Surgery(Electronic Edition)

摘　　要：目的总结腹腔镜同期手术治疗结肠癌肝转移并盆腔转移的技术体会,探讨其在治疗此类疾病中的安全性及可行性。方法回顾性分析2021年6月西安交通大学第一附属医院1例结肠癌肝转移并盆腔转移患者的临床资料及诊疗过程。结果患者接受同期腹腔镜右半结肠切除、肝转移癌切除、全子宫及双侧附件切除,均顺利实现R0切除,总手术时间330 min,术中出血量100 ml,术后恢复顺利,辅助腹腔热灌注化学药物治疗。病理结果提示:结肠溃疡型中分化腺癌,侵及子宫肌壁深肌层及双侧卵巢组织、宫颈,肝组织内有中分化腺癌浸润,肠周(2/30个)淋巴结有癌转移。患者术后1个月复查腹部CT,肿瘤标志物未见明显异常,目前继续严密随访中。结论腹腔镜同期手术对于结肠癌肝转移并盆腔转移的治疗是安全、可行的,同时具有创伤小、恢复快、切口美观等优点,多学科诊疗模式对于提高患者临床获益具有重要作用,值得推广。Objective To summarize the experience of laparoscopic concurrent surgery in the treatment of colon cancer liver metastasis and pelvic metastasis,and to explore its safety and feasibility in the treatment process.Methods A retrospective analysis of the clinical data and diagnosis and treatment process of a patient with liver metastasis from colon cancer and pelvic metastasis in the First Affiliated Hospital of Xi′an Jiaotong University in Jun.2021.Results The patient received simultaneous laparoscopic resection of the right colon for liver metastatic cancer,complete hysterectomy and bilateral adnexectomy,and R0 resection was successfully achieved.The total operative time was 330 min,and the bleeding was 100 ml.Peritoneal hyperthermic perfusion chemotherapy was assisted.Pathological results showed that colonic ulcerative moderately differentiated adenocarcinoma invaded the deep myometrium of the uterine wall and bilateral ovarian cervix,infiltrated in liver tissue,and metastatic in periintestinal lymph nodes(2/30).The abdominal CT and tumor markers showed no abnormalities one month after the operation.At present,the patient is continuing to follow up closely.Conclusions Simultaneous laparoscopic surgery is safe and feasible for the treatment of colon cancer liver metastases and pelvic metastases.It also has the advantages of less trauma,fast recovery,and beautiful incisions.The MDT mode plays an important role in improving the clinical benefits of patients and is worthy of promotion.

关 键 词：结肠癌肝转移 盆腔转移 腹腔镜 同期手术 

分 类 号：R73[医药卫生—肿瘤]