对大肠癌手术治疗避免播散种植的临床分析_临床医学论文.docVIP

对大肠癌手术治疗避免播散种植的临床分析_临床医学论文 对大肠癌手术治疗避免播散种植的临床分析_临床医学论文 【关键词】 大肠癌 摘 要：目的：探讨大肠癌手术治疗中防范癌细胞播散、种植的有效措施。方法：回顾性分析1999年至2004年同期国内正式发表的3篇有关大肠癌术前化疗与术后复发再手术治疗的临床资料。结果：大肠癌术后复发2年内占78.05％(64／82)，再次切除其根治性切除率51.25％(41／80)，姑息性切除37.50％（30／80)。术前化疗病理显示：癌细胞均有不同程度的坏死和变性。结论：大肠癌预防术后复发重在术前术中化疗，术中无瘤操作，术后严密随访、早期诊断、以手术为主辅助化疗的综合治疗，对减少癌细胞播散、种植、减少复发转移与提高生存质量有好处。 关键词： 手术治疗; 大肠肿瘤; 化 疗; 防范癌细胞; 播散种植 The Clinical Analysis of Avoid Spreading and Planting of the Colon Cancer in Operation Treatment Abstract: Objective: Studying the effective measures to prevent the cells of colon cancer to spread and plant. Method: Reviewed analysis the clinical materials to 3 reports of national published at same period of the colon cancer of neoadjuvant chemotherapy and the second-operation because it is recurred after opration. Result: The recur rate after operation of the colon cancer is 78.05%(64/82) in 2 years; The radical cut rate of the second operation is 51.25%(41/80); The appease cut rate of the second operation is 37.50%(30/80). The pathology of the neo-adjuvant chemotherapy showed that the cancer cells have death and deteriorate in different degree. Conclusion: The key to prevent colon cancer to recur depend on the chemotherapy in the operation and preoperation. The general treatment, such as the non-tumor operation, the exact follow observation after operation, the early diagnosis and the adjuvant chemotherapy is benefit to decrease the cancer cells to spread and plant, to reduce the tumor recur and metastasis. Key words: The operation; Colon cancer; Chemotherapy; Preventing cancer cells to spread and plant 大肠癌是消化道常见的恶性肿瘤之一，早期播散方式主要为直接浸润和淋巴道转移。手术切除后复发转移是导致手术失败或病人死亡的主要原因。本文回顾性分析近年来有关大肠癌术后复发与术前区域动脉灌注化疗的报导，探讨大肠癌治疗中如何减少或必免医源性种植播散，提高术后复发、转移的治疗效果。讨论分析如下： 1 临床资料 1.1 本文收集1999年至2004年同期国内正式发表的3篇有关大肠癌术前化疗与术后复发再手术治疗的报导，其回顾性分析的病例为1997年至2003年内治疗的病人。其中手术组与术前化疗的病人共计112例：男72例，女40例。年龄25～81岁。结肠癌70例(其中1例为降结肠及直肠部位均有癌肿)，直肠癌43例。病理类型：管状腺癌67例(其中可分清分化程度的45例：高分化11例、中分化28例、低分化6例)，粘液腺癌32例，乳头状腺癌8例，印戒细胞癌1例，未分型4例。临床Dukes分期：A期6例，B期