INTRODUCTIONCarcinoembryonic antigen ( CEA) , originally described by Gold and Freedman [1] in 1965, is now an acknowledged member of immunoglobulin superfamily[2],with a role as an intracellular adhesion molecule[3]....INTRODUCTIONCarcinoembryonic antigen ( CEA) , originally described by Gold and Freedman [1] in 1965, is now an acknowledged member of immunoglobulin superfamily[2],with a role as an intracellular adhesion molecule[3].Carbohydrate antigen 19-9(CA19-9), obtained with a monoclonal antibody produced by immunizing a monoclonal antibody produced by immunizing a mouse with a colonic cancer cell line in 1979[4],is a ligand for E-selectin that plays an important role in the addhesion of cancer cells to endothelial cells [5,6].展开更多
第一例腹腔镜结直肠手术首先由 Jacobs et al 于1990年开展,经过近十年的发展,目前国外有比较多的报道,国内开展该手术的医院也越来越多,手术例数也逐渐缓慢增加,开展的手术种类有结肠部分切除、左右半结肠切除术、全结肠切除术、横结...第一例腹腔镜结直肠手术首先由 Jacobs et al 于1990年开展,经过近十年的发展,目前国外有比较多的报道,国内开展该手术的医院也越来越多,手术例数也逐渐缓慢增加,开展的手术种类有结肠部分切除、左右半结肠切除术、全结肠切除术、横结肠切除术、直乙结肠肿瘤切除术(Miles 手术、Dixon 手术)、结肠造瘘等,手术指征为结肠良性病变及早期及中晚期结肠癌,DukesA～D期的患者都有报告.腹腔镜手术的目的是为了减少腹壁伤口创伤、缩短术后恢复时间及获得和开腹手术一样的手术效果;其腹壁切口小、胃肠道干扰小、手术后痛苦少、下床活动早、胃肠道功能恢复快,并且手术中肿瘤受挤压小,手术视野开扩清楚,手术后恢复快,免疫功能受影响小,术后可较早接受其他治疗,是其优点.但是其手术技术要求高,并且手术费用也高是其缺点.腹腔镜结肠手术切除良性肿瘤效果优良,我们曾经有2例较大的结肠腺瘤患者,经腹腔镜行肿瘤段结肠部分切除后,效果很满意.对于结直肠癌的患者,仍然存在着争议,比较多的医生怀疑其肿瘤根治的彻底性,早期的报告发生穿刺口肿瘤转移的也比较多.我们认为手术者应该严格遵守传统开放手术的手术原则,技术上是可以达到开放手术的根治范围的,当然这与手术者的腹腔镜技术掌握程度及经验有比较密切的关系.1穿刺口转移腹壁小切口的肿瘤复发,文献有不少的报道。展开更多
基金This study was supported by the research grant from Administration of Key Disciplines for"Project 211"of Sun Yat-Sen University of Medical Sciences,Grant No.98097.
文摘INTRODUCTIONCarcinoembryonic antigen ( CEA) , originally described by Gold and Freedman [1] in 1965, is now an acknowledged member of immunoglobulin superfamily[2],with a role as an intracellular adhesion molecule[3].Carbohydrate antigen 19-9(CA19-9), obtained with a monoclonal antibody produced by immunizing a monoclonal antibody produced by immunizing a mouse with a colonic cancer cell line in 1979[4],is a ligand for E-selectin that plays an important role in the addhesion of cancer cells to endothelial cells [5,6].
文摘第一例腹腔镜结直肠手术首先由 Jacobs et al 于1990年开展,经过近十年的发展,目前国外有比较多的报道,国内开展该手术的医院也越来越多,手术例数也逐渐缓慢增加,开展的手术种类有结肠部分切除、左右半结肠切除术、全结肠切除术、横结肠切除术、直乙结肠肿瘤切除术(Miles 手术、Dixon 手术)、结肠造瘘等,手术指征为结肠良性病变及早期及中晚期结肠癌,DukesA～D期的患者都有报告.腹腔镜手术的目的是为了减少腹壁伤口创伤、缩短术后恢复时间及获得和开腹手术一样的手术效果;其腹壁切口小、胃肠道干扰小、手术后痛苦少、下床活动早、胃肠道功能恢复快,并且手术中肿瘤受挤压小,手术视野开扩清楚,手术后恢复快,免疫功能受影响小,术后可较早接受其他治疗,是其优点.但是其手术技术要求高,并且手术费用也高是其缺点.腹腔镜结肠手术切除良性肿瘤效果优良,我们曾经有2例较大的结肠腺瘤患者,经腹腔镜行肿瘤段结肠部分切除后,效果很满意.对于结直肠癌的患者,仍然存在着争议,比较多的医生怀疑其肿瘤根治的彻底性,早期的报告发生穿刺口肿瘤转移的也比较多.我们认为手术者应该严格遵守传统开放手术的手术原则,技术上是可以达到开放手术的根治范围的,当然这与手术者的腹腔镜技术掌握程度及经验有比较密切的关系.1穿刺口转移腹壁小切口的肿瘤复发,文献有不少的报道。
