不同阶段结直肠癌肝转移的手术策略

Surgical strategies for colorectal liver metastases in different stages

  • 摘要: 结直肠癌患者容易发生肝转移,手术是目前治疗结直肠癌肝转移的最佳手段。但肝转移的发生时机不同,所采取的手术策略也不同。结直肠癌确诊时发生肝转移的患者,其手术时机一直存在争议;结直肠癌根治术后发生肝转移的患者只要具有手术指征,均应再次实施手术治疗;部分暂不能手术的结直肠癌肝转移患者,多采用化疗、RFA、介入等辅助治疗可使患者重新获得手术机会,但在临床应用中也存在不少困惑。因此,针对不同阶段的结直肠癌肝转移,应采用多学科综合治疗,制订个体化的治疗方案才是改善患者预后的关键。

     

    Abstract: Colorectal cancer is easily metastasized to the liver. Surgical treatment is the best choice for the treatment of colorectal cancer, while the treatment strategy should be selected according to different stages of colorectal liver metastases. Liver metastases occurred at the definite diagnosis of colorectal cancer or within 6 months after radical resection of colorectal cancer are synchronous liver metastases, the timing of synchronous liver metastases resection is still under controversy. Liver metastases occurred at 6 months after radical resection are metachronous liver metastases, and for patients with metachronous liver metastases, reoperation should be applied if the indications are clear. Chemotherapy, radiofrequency ablation and interventional therapy provide chances of reoperation for patients who originally cannot received surgical treatment, while confusion exists in their clinical application. Therefore, multi disciplinary treatment based on individualized condition evaluation is the key point in improving the prognosis of patients with colorectal liver metastases in different stages.

     

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