Rosell Pradas J, Astruc Hoffmann A, Ruiz de Adana A, Vara Thorbeck R
Cátedra de Patología y Clínica Quirúrgica, Hospital Universitario, Granada.
Rev Esp Enferm Dig. 1993 Jun;83(6):429-33.
We evaluated minimally aggressive surgery in the treatment of metastasic cancer of the colon in 6 patients: 2 females and 4 males, with an average age of 71.8. Preoperative studies showed cancer of the colon (right colon = 4; sigmoid colon = 2) with multiple hepatic metastasis. In all cases laparoscopic mobilization and extracorporeal resection with end-to-end anastomosis was performed employing a biofragmentable anastomotic ring. In two patients laparoscopy discovered peritoneal carcinomatosis. One patient was operated using conventional surgery. Intestinal segments with an average length of 21.3 cm were removed, with a mean of 13.5 lymph-nodes per patient, 70.3% of which had metastasis. Eleven of the 12 resection lines were tumor-free (91.6%). Hospital stay averaged 7.8 days, and mean survival has been 4.5 months. Only two patients, those with peritoneal carcinomatosis, had post-operative complications. If an appropriate patient selection is followed: cancer of the colon with hepatic metastasis and no peritoneal spread, laparoscopic surgery is a reliable and effective treatment for advaned cancer of the colon.
我们评估了微创侵袭性手术对6例结肠癌转移患者的治疗效果:2例女性,4例男性,平均年龄71.8岁。术前研究显示为结肠癌(右半结肠4例;乙状结肠2例)伴多发肝转移。所有病例均采用生物可降解吻合环进行腹腔镜游离和体外切除并端端吻合。2例患者经腹腔镜发现腹膜癌转移。1例患者采用传统手术。平均切除肠段长度为21.3 cm,每位患者平均切除13.5个淋巴结,其中70.3%有转移。12条切除线中有11条无肿瘤(91.6%)。平均住院时间为7.8天,平均生存期为4.5个月。仅2例腹膜癌转移患者出现术后并发症。如果遵循合适的患者选择标准:结肠癌伴肝转移且无腹膜播散,腹腔镜手术是晚期结肠癌可靠且有效的治疗方法。