摘要
目的探讨局部晚期结直肠癌患者的手术方式。方法回顾性分析本院2006年1月至2016年12月收治的255例局部晚期结直肠癌患者的临床资料。将39例行联合脏器R0切除术的患者纳入联合脏器切除组,136例行姑息R1或R2切除术的患者纳入姑息性切除组,80例无法手术切除行单纯造瘘术或肠侧侧吻合术的患者纳入单纯造瘘组。比较不同手术方式组患者的手术时间、术中出血量、术中输血量、住院天数及术后并发症发生情况,并对三组患者进行生存分析。结果三组患者手术时间、术中出血量及术中输血量比较均有显著差异(P_均=0.001),住院天数和术后并发症三组间比较均无显著差异(P=0.120,P=0.654)。生存分析结果显示,联合脏器切除组、姑息性切除组及单纯造瘘组患者术后1年生存率分别为91.72%、81.46%及58.33%,术后3年生存率分别为67.97%、36.67%及33.50%。三组患者生存率比较差异具有显著性(P=0.0003)。结论联合脏器切除将是提高局部晚期结直肠癌患者术后生存率的重要手术方式。
Objective To investigate the surgical methods of patients with locally advanced colorectal cancer. Method Clinical data of 258 patients with local advanced colorectal cancer were analyzed retrospectively from January 2006 to December 2016.39 patients who underwent multi-visceral R0 resection were included in multi-visceral resection group, and 136 patients who underwent palliative R1 or R2 resection were included in palliative resection group, and 80 patients who could not be surgically resected for simple fistula or lateral intestinal anastomosis were included in fistula formation group. The operation time, intxaoperative blood loss, intraoperative blood transfusion, length of hospital stay and postoperative complications were statistically compared in different surgical groups. Survival analysis was conducted for the prognosis of patients with different surgical methods. Result The differences of operation time, intraoperative blood loss and intraoperative blood transfusion in groups of multi-visceral resection, palliative resection and fistula formation were statistically significant （P all = 0.001）. The difference of length of hospital stay and postoperative complications in three groups was not statistically significant （P= 0.120, P = 0.654）. The 1-year survival rate was 91.72%, 81.46% and 58.33%, and the 3-year survival rate was 67.97%, 36.67% and 33.50% in groups of multi-visceral resection, palliative resection and fistula formation. The difference of survival ratein three groups had statistical significance （P = 0.0003）. Conclusion For patients with local advanced colorectal cancer, multivisceral resection is an important operation method, which may improve the postoperative survival rate.
作者
郭瑞
石刚
闫晓菲
刘信
张睿
马思平
GUO Rui;SHI Gang;YAN Xiao-fei;LIU Xin;ZHANG Rui;MA Si-ping(Department of Colorectal Surgery,Cancer Hospital of China Medical University,Liaoning Cancer Hospital ＆ Institute,Shenyang 110042,China)
出处
《肿瘤综合治疗电子杂志》
2018年第3期57-60,共4页
Journal of Multidisciplinary Cancer Management(Electronic Version)
基金
辽宁省临床能力建设项目(LNCCC-D44-2015)
关键词
结直肠癌
局部晚期
联合脏器切除
生存分析
Colorectal cancer
Locally advanced
Multivisceral resection
Survival analysis
