进一步提高大肠癌的治疗效果

Further improve the result of treatment for colorectal cancer

目的 重视提高大肠癌手术治疗效果。方法 复习近年来的文献并结合我国大肠癌外科治疗的实际情况。评述改善治疗效果的有关问题。结果 大肠癌的治疗效果在根治性切除率、手术死亡和并发症发生率、术后局部复发、吻合口漏发生以及生存率等方面 ,各医院和不同的外科医生之间都存在很大差别。手术技术、医生的学识和经验都会影响治疗效果。辅助放化疗已证明能提高手术切除率和术后生存率、降低复发率。新的抗癌药物和其它药物的推出可增加肝转移癌的切除机会 ,并延长晚期患者的生存期。

Objective To pay attention to further improving the result of treatment for colorectal cancer (CRC). Methods On the basis of reviewing the current literature, in view of the present situation of the surgical care for CRC patients the issues of improving the treatment of CRC were appraised. Results There is a great discrepancy in the results of surgical treatment for CRC from different hospitals and among different surgeons in terms of the rates of curative resection, operative mortality and morbidity, local recurrence, anastomotic leakage and overall survival. Surgical technique and the knowledge as well as the experience of the surgeons may have an impact on the outcome. Adjuvant chemotherapy and radiation therapy have contributed to the increase of resectability and survival reate and decrease of the recurrence rate after surgery. The availability of new cytostatic agents and other drugs may improve the resectability of liver metastases and prolong the survival in advanced disease. Conclusions Strengthening the specialty training of surgical personals and emphasizing the application of standard adjuvant therapy are the key points for further improving the result of treatment for CRC and other malignancies.