局部进展期大肠癌扩大切除术的临床应用

Clinical Application of Extended Resection for Locally Advanced Colorectal Carcinoma

目的 探讨局部进展期大肠癌扩大根治术并发症的防治 ,评价其疗效。 方法 对 68例行扩大根治术的结直肠癌病例的临床资料进行回顾性分析。 结果 手术并发症发生率为 16 2 % ( 11/68) ,死亡率为 1 5 % ( 1/68) ,与常规的根治手术无显著性差异。术后 5年生存率为 5 2 9% ( 3 6/68) ,其中恶性程度高的粘液腺癌和未分化癌低于其他类型肿瘤 ,淋巴结转移达N3 期者疗效显著下降。 结论 对于扩大根治术 ,防止并发症的关键是围手术期处理和切除范围的选择 ,提高生存率应从确保局部无肿瘤残存和足够的淋巴清除范围方面努力。

Objective To explore the prevention and cure of the radical extended surgical complications in the patients with locally advanced colorectal carcinoma (LACC),and to estimate the effects of extended resection. Methods The clinical data of 68 LACC patients who received extended resection were retrospectively analyzed. Results The incident morbidity was 16.2% (11/68),and the mortality rate was 1.5% (1/68).The 5-year survival rate was 52.9% (36/68).In the patients with mucinous carcinoma and nondifferentiated carcinoma,the 5-year survival rate was significantly lower than that in those with other subtypes.When the lymph nodal stage was N 3,the curative effect of the operation was significantly decreased.[WT5”HZ] Conclusion[WT5”BZ] In extended resection for LACC,appropriate perioperative management and excisional range selection are most important to prevent complications.To improve the survival rate,great efforts should be made to ensure non-residual tumor and adequate lymph node dissection.