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目的 探讨晚期直肠癌的外科治疗方法。方法 回顾性分析 1994～ 1999年收治的 5 5例晚期直肠癌的临床资料。结果 均为DukesD期或肝转移病例。行Hartmann术式 11例 ,单腔乙状结肠造口术 13例 ,双腔乙状结肠造口 11例 ,横结肠造口 1例。肝转移癌切除 7例。其中直肠上动脉置管化疗 2 0例 ,肝动脉置管化疗 12例。行Hartmann术式者 3年生存率为 2 7% (3/ 11) ,肝动脉置管化疗组和直肠上动脉置管化疗组平均生存期为14个月 ,未切除或未行肝动脉置管化疗的肝转移癌及非手术治疗组平均生存期 10个月。结论 姑息性手术和乙状结肠造口术主要用于治疗晚期直肠癌 ,不能切除的原发灶或肝转移灶可选择肝动脉或直肠上动脉置管化疗。姑息性手术、乙状结肠造口术及肝动脉或直肠上动脉置管化疗可解除梗阻、缓解疼痛症状 ,并能提高生活质量 ,延长生存期
Objective To investigate the surgical treatment of advanced colorectal cancer. Methods The clinical data of 55 patients with advanced colorectal cancer admitted from 1994 to 1999 were retrospectively analyzed. The results were DukesD or liver metastases. Row Hartmann operation in 11 cases, single-chamber sigmoid colonostomy in 13 cases, double-lumen sigmoid colon in 11 cases, transverse colonostomy in 1 case. Liver metastases resection in 7 cases. Among them, 20 cases received rectal artery catheterization chemotherapy and 12 cases received hepatic artery catheterization chemotherapy. The 3-year survival rate was 27% (3/11) in Hartmann’s surgery group, 14 months in hepatic artery catheterized chemotherapy group and rectal arterial catheterized chemotherapy group, and the unchecked or non-hepatic arterial catheterization The average survival of patients with liver cancer and non-surgical treatment of chemotherapy was 10 months. Conclusions Palliative surgery and sigmoidostomy are mainly used for the treatment of advanced rectal cancer. Hepatic artery or rectal artery catheterization chemotherapy can be selected for unresectable primary or hepatic metastases. Palliative surgery, sigmoidostomy and hepatic artery or rectal artery catheter chemotherapy can relieve the obstruction, relieve pain symptoms, and can improve the quality of life and prolong survival