大肠癌肝转移的诊断及外科治疗

The diagnosis and surgical treatment of liver metastasis in colorectal cancer

对196例大肠癌肝转移患者的临床病理特点及表现进行分析,结果显示:①87.8％的病人血清CEA升高;②B超与CT对检测原发灶复发及转移性肝癌是十分必要;③对肝转移灶,可视病人的具体情况选择与大肠癌同时或分期切除;④单个孤立或局限于一段的多个肝转移灶在行楔形或肝段切除后,其预后不逊于肝叶切除。作者认为,早期发现肝转移灶,把握手术时机与适应证,严格掌握手术指征和切除范围,是提高手术切除成功率及存活率的关键。

Clinical and pathological characterize of 196 cases with colorectal cancer com-panying by hepatic metastasis were studied. The results showed that;(l)The serum level of CEA was increased in 87- 8% patients. The time of occuring relapse or metastasis remarkably shortened when serum level of CEA could not return to normal after operation; (2)The effect of wedge resection or segmentectomy on some hepatic metastatic nodulse localising singy in one segmental was same as lobectomy section; (3)The hepatectomy may perform at same or different time as coloproctectomy ,depending on the general condition of patients. They are key factors in improving operation and survival rate to discover hepatic metastasis focus earlier,control the operation chance and adaptation,master operation signs and scope.