复发性大肠癌51例再手术治疗分析

Re-operation of 51 Patients with Recurrent Colorectal Carcinoma

目的探讨提高复发性大肠癌生存率的治疗方法。方法回顾性分析我院1999年以来复发性大肠癌再手术病例51例的临床资料,其中单纯肝转移14例,单纯吻合口复发9例,腹腔广泛转移12例,单纯腹膜后淋巴结转移6例,盆腔转移10例;再次手术共切除25例,行肠造口术、肠吻合短路手术10例,单纯置化疗泵共7例,行单纯剖腹探查术9例。结果术后42例获随访,5例已存活5年,6例已存活3年,4例手术距今不足3年仍存活,7例2年内死亡,20例1年内死亡。结论大肠癌复发再次手术仍有较高切除率,再次手术治疗能提高生存率。

Objective To investigate the method which can improve the survival rate of recurrent colorectal carcinoma.Methods The clinical data of 51 cases with recurrent colorectal carcinoma were analyzed retrospectively.Of the 51 patients,there were 14 cases of liver metastasis,9 cases of local recurrence,12 cases of abdominal cavity widespread metastasis,6 cases of retroperitoneal lymph node metastasis and 10 cases of pelvic cavity metastasis.Re-excision was performed in 25 cases,which included enterostomy and intestinal anastomosis in 10 cases,cannulation including the hepatic vascular access device cannulated in 7 cases,simple laparotomy in 9 cases.Results 42 patients were followed after re-operation.The survival time was more than 5 years in 5 patients,3 years in 6 patients.7 patients died within 2 years after re-operation,20 patients died within one year postoperatively.Conclusion The resection rate of re-operation for recurrent colorectal carcinoma was high,and re-operation can increase the survival rate in patients with recurrent colorectal cancer.