结直肠癌伴肝转移的微创手术方法探讨

Minimally invasive surgery for colorectal cancer with liver metastasis

目的探讨同期治疗同时性结直肠癌肝转移的微创手术方法。方法对浙江大学邵逸夫医院2006年3月至2008年6月5例同时性结直肠癌伴肝转移的典型病例，采用5种不同形式的微创手术方法治疗的临床资料进行回顾性分析。结果5例均行腹腔镜结直肠肿块切除，对不同肝转移灶1例开腹切除，1例腹腔镜辅助下切除，1例完全腹腔镜下切除，1例腹腔镜下切除＋射频消融，1例综合治疗。平均手术时间177min，平均出血量126ml，术后胃肠恢复时间为48～72h，住院时间平均7d。随访10～27个月，肝脏转移灶复发1例，死亡1例。结论微创手术方式同期治疗同时性结直肠癌肝转移是一种可供选择的理想术式。

Objective To investigate the minimal invasive surgery for simultaneously treating synchronous colorectal cancer with liver metastasis. Methods From the clinical data of our department between March 2006 to June 2008, retrospectively reviewed and analyzed 5 typical cases of synchronous colorectal cancer with liver metastasis. All were treated with 5 different strategies of minimal invasive surgery. Results All underwent laparoscopic colorectal surgery, i.e. open hepatectomy, laparoseopic- assisted hepatectomy, laparoscopic hepatectomy, laparoscopic hepatectomy plus radiofrequency ablation and multiple therapy respectively. The mean operative time was 177 minutes, the mean blood loss 126 ml, the time of gastrointestinal function recovery 48 - 72 hours and the mean hospital stay 7 days. In the follow-up of 10 -27 months for all 5 patients, one suffered hepatic recurrence and one died. Conclusion Simultaneous minimal invasive surgery is an optional and ideal method for treating synchronous colorectal cancer with liver metastasis.