姑息性手术在结直肠癌治疗中的地位
Signification of palliative operation in the treatment of colorectal cancer
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摘要:
结直肠癌在术前影像学规范评价的基础上追求肿瘤R0切除的理念已获得广泛共识。外科医师应科学严谨地评价肿瘤的可切除性,最大限度地避免手术残留肿瘤。初始不可R0切除的患者推荐优先考虑转化性治疗,争取实现转化治疗后肿瘤R0切除。针对临床综合评价确认无法获得R0切除的患者,选择姑息性手术也应严格掌握适应证,并做到有计划和目的性明确。目前姑息性手术或者减瘤手术可以带来生存获益的结论尚无证据,以最小的创伤,达到解除合并症和改善患者生命质量的目标是基本原则。
Abstract:The principle of R0 resection for colorectal cancer (CRC) has been widely accepted based on the preoperative imaging evaluation. The surgeons should scientifically and strictly assess resectability of tumors and furthest reduce tumor residuals. Patients with initial unresectable CRC will give priority to conversion therapy and then undergo R0 resection if converting into resectable tumors. Palliative operation for the patients who cannot receive R0 resection according to the clinical assessment should strictly follow surgical indications and achieve wellplanned and clear surgical purposes. There is no evidence that the palliative operation or cytoreductive surgery benefits to survival of patients, and decreasing complications and improving quality of life through minimum wound are the basic principles.
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Keywords:
- Colonic neoplasms /
- Rectal neoplasms /
- Roresection /
- Palliative operation
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