结直肠癌肺转移的外科治疗
Surgical management of colorectal lung metastasis.
作者信息
Villeneuve P James, Sundaresan R Sudhir
机构信息
Division of Thoracic Surgery, The Ottawa Hospital, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada.
出版信息
Clin Colon Rectal Surg. 2009 Nov;22(4):233-41. doi: 10.1055/s-0029-1242463.
Abstract
Colon cancer is a systemic disease in 19% of patients and metastasizes most frequently to the liver and the lung. Survival is enhanced with complete surgical resection of pulmonary metastases. Comprehensive restaging and verification of preoperative fitness must precede resection. The operative approach is dictated by the anatomic location of the metastases, whereas the extent of resection remains a balance between complete removal of metastatic deposits while preserving as much lung parenchyma as possible. The presence of metastatic involvement of hilar and mediastinal lymph nodes is ominous. Multidisciplinary care is highly recommended. An evidence-based algorithm for the identification assessment and treatment of patients with pulmonary metastases is proposed.
摘要
19%的结肠癌患者所患疾病为全身性疾病，最常转移至肝脏和肺部。肺转移瘤完整切除可提高生存率。手术切除前必须进行全面的再分期及术前身体状况核查。手术方式取决于转移瘤的解剖位置，而切除范围则需在彻底清除转移灶与尽可能保留肺实质之间取得平衡。肺门和纵隔淋巴结存在转移受累情况预后不佳。强烈建议多学科协作治疗。本文提出了一种基于证据的用于识别、评估和治疗肺转移患者的算法。
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