Fazio V W, Tjandra J J
Department of Colorectal Surgery, Cleveland Clinic Foundation, Ohio 44106.
World J Surg. 1991 Sep-Oct;15(5):568-75. doi: 10.1007/BF01789200.
Most colonic and rectal carcinomas are treated by excision, usually with the object of cure. Adequate and safe resection depends upon sound understanding of the anatomy and pathology of the tumor. The surgical options in various clinical situations are discussed but the final choice has to be individualized. Improved understanding of the biology of large bowel cancer and the advent of circular stapling devices have significantly altered the surgical practice in large bowel cancer. Despite these innovative advances, there has only been a modest improvement in survival over the last few decades. This is because the concept of "sequential tumor spread" does not always hold true. Systemic adjuvant therapy that is effective and safe is needed for selected patients. Notwithstanding, surgical resection remains the most effective therapy for large bowel cancer.
大多数结肠癌和直肠癌通过切除进行治疗，通常目的是治愈。充分且安全的切除取决于对肿瘤解剖学和病理学的透彻理解。文中讨论了各种临床情况下的手术选择，但最终选择必须因人而异。对大肠癌生物学的进一步理解以及圆形吻合器的出现显著改变了大肠癌的手术方式。尽管有这些创新性进展，但在过去几十年中生存率仅略有提高。这是因为“肿瘤序贯扩散”的概念并不总是成立。对于选定的患者，需要有效且安全的全身辅助治疗。尽管如此，手术切除仍然是治疗大肠癌最有效的方法。
