结直肠癌外科手术的原则与进展

Complications following laparoscopic and open radical resection of colorectal cancer

  • 摘要: 结直肠癌是人类常见的恶性肿瘤之一。早诊断是改善结直肠癌患者预后的关键,对进展期及晚期肿患者实施规范化的手术和综合治疗也能够改善治疗效果。于结肠癌的淋巴结转移规律以及完整结肠系膜切除理论,肠癌的手术治疗已经进入规范化和标准化的时代。而在全肠系膜切除术(TME)金标准的基础上,直肠癌尤其是低位肠癌手术方式更需考虑个体化。结直肠癌肝转移虽然是晚疾病,但关于其治疗的研究非常活跃,对于可切除的结直肠肝转移肿瘤,肝切除是标准治疗方法,并且也是惟一可能治的方法。因此,判断结直肠癌肝转移的可切除性显得尤为重要。外科医师是结直肠癌诊断治疗临床实践的最重要与者,规范化的诊断与治疗是改善患者预后的关键所在。

     

    Abstract:

    Colorectal cancer is one of the most common malignancies in human. Early diagnosis is the key points in improving the prognosis of patients with colorectal cancer. The implementation of standardized operation and comprehensive treatment for advanced and late stage cancer can improve the outcome. Based on the pattern of lymph node metastasis and the concept of complete mesocolic excision, the operation of colonic cancer has entered the era of normalization and standardization. The surgical procedure of rectal cancer (especially low rectal cancer) should be individualized based on the gold standard of total mesorectal excision (TME). For hepatic metastasis of colorectal cancer, hepatectomy is currently the standard and the only potentially curative treatment method. Therefore, how to evaluate the resectability of hepatic metastasis of colorectal cancer is particularly important. Surgeons are the most important participants in the diagnosis and treatment of colorectal cancer, and standardized diagnosis and treatment is the key to improve the prognosis of patients.

     

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