目的 探讨再次肝切除手术对结直肠癌肝转移复发患者的临床疗效和生存情况的影响因素.方法 回顾性分析94例结直肠癌肝转移复发患者临床相关资料,其中38例行再次肝切除术(观察组),其他56例进行内科化疗(对照组).结果 分别进行再次手术和化疗后,结直肠癌肝转移复发患者的1、3、5年生存率观察组为81.6%、52.6%和31.6%;对照组为62.5%、21.4%、7.1%,观察组患者生存率显著高于对照组(P<0.05).针对结直肠癌肝转移复发患者再次切除术的预后可能影响因素进行分析,其中癌直径大小、复发转移灶个数、切缘情况与患者5年生存率有关(P<0.05).术后并发症发生率为28.9%,均经过对症处理可耐受.结论 对于结直肠癌肝转移复发患者,再次肝切除术能提高远期疗效,对于癌直径较小、复发转移灶个数少、切缘阳性的患者效果更好.%Objective To study the clinical curative effect of repeat liver resection in patients with recurrent colorectal liver metastases and the influence factors of survival situation .Methods Retrospective analysis of clinical data of 94 cases of re-current colorectal liver metastases were conducted ,including 38 patients(the observation group)underwent resection of the liver a-gain;and 56 cases received chemotherapy as the control group .Results Respectively after surgery and chemotherapy , patients with recurrent colorectal liver metastases ,1-,3-,5-year survival rates in the observation group were 81.6%,52.6%and 31.6%;The observation group were 62.5%,21.4%,7.1%,survival rates of the observation group were significantly higher than those of the control group(P<0.05).Prognostic factors of patients with recurrent colorectal liver metastases resection again were ana -lyzed;tumor size,number of metastatic recurrence,cutting edge were associated with 5-year survival rate(P<0.05).The inci-dence of postoperative complications was 28.9%,after symptomatic treatment can be tolerated .Conclusion For patients with re-current colorectal cancer liver metastasis ,liver resection again can improve long-term efficacy ,patients with small tumor diameter , fewer metastatic recurrence sites ,cutting edge positive have better prognosis effect .
展开▼
