腹腔镜下同期治疗结直肠癌并肝转移的临床观察

Laparoscopic treatment of colorectal cancer with synchronous hepatic metastasis

目的探讨腹腔镜下行结直肠癌切除术同时处理合并肝转移癌的疗效。方法对32例结直肠癌合并肝转移患者行腹腔镜下结直肠癌切除手术,同时利用腹腔镜直视下切除或射频消融等方法治疗肝转移癌。结果 32例患者手术过程顺利,手术时间为220～384min,平均280min,出血量为240～1300ml,无严重并发症发生。随访6～32月,18例存活,7例死于肺、脑或腹腔转移,3例死于复发,2例死于脑出血,2例死于心肌梗塞。结论利用腹腔镜直视下治疗结直肠癌并肝转移安全有效,可避免二期手术的创伤。

Objective To explore the laparoscopic treatment of colorectal cancer with synchronous hepatic metastasis at the same stage. Methods Thirty-two colorectal cancer patients with synchronous hepatic metastasis received laparoscopic resection of colorectal cancer, laparoscopic resection of liver metastases and radiofrequency ablation treatment of liver cancer under direct vision at the same time. Results The operations were performed well. The duration of operations was 280 min （range 220-384min）. The a- mount of bleeding ranged from 240 to 1300ml. No serious complications occurred. All the patients were followed up for 6-32 months af- ter operation, among whom 18 patients were still alive. Seven patients died due to lung, brain or abdominal cavity metastases, 3 pa- tients due to recidivation, 2 patients of brain hemorrhage and 2 patients of myocardial infarction. Conclusion The treatment of color- ectal cancer with synchronous hepatic metastasis using laparoscopic resection of colorectal cancer and liver metastases, as well as radio- frequency ablation methods at the same stage is safe and effective and the trauma in second stage surgery can be avoided.