结直肠癌肝转移及合并肝外转移手术治疗现状

Current status of the operative treatment for colorectal cancer with liver metastases and concurrent extrahepatic metastases

目前,结直肠癌已成为一种常见疾病,并逐渐朝着年轻化的趋势发展。结直肠癌远处转移最常见的部位为肝脏,占50%以上,原因是结直肠静脉血通常是经过门静脉进入肝脏,癌细胞极易转移至肝脏。手术切除是结直肠癌肝转移(colorectal liver metastases,CRLM)最有效的治疗方法。此外,随着手术观念和技术的革新以及综合治疗手段的不断完善,初始不可切除的CRLM、CRLM同时合并肝外转移(肝门淋巴结、肺、骨、腹腔转移等)已经不再是绝对的手术禁忌证。本文将对初始可切除CRLM、初始不可切除CRLM、CRLM同时合并肝外转移三种情形的手术治疗及相关问题分别进行综述。

With the worsening environment and lifestyle,colorectal cancer has become a common disease and has a tendency to occur at a younger age. The most common distant metastasis of colorectal cancer is liver）. Surgical resection is the best treatment for colorectal liver metastases（ CRLM）. Moreover,with the operational idea and technology innovation as well as continuous improvement of the comprehensive treatment,colorectal cancer spreading to liver and extrahepatic sites（ hilar lymph nodes,lung,bone,peritoneum,etc.） are not entirely surgically contraindicated. This article separately discusses three kinds of situations： resectable colorectal liver metastases,initially unresectable colorectal liver metastases,colorectal cancer with concurrent liver and extrahepatic metastases.