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題名 | Surgical Treatment of Recurrent Colorectal Cancer in the Pelvis=骨盆腔復發大腸直腸癌之手術治療 |
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作者 | 賴正大; 許自齊; | 書刊名 | 中華民國大腸直腸外科醫學會雜誌 |
卷期 | 24:3 2013.09[民102.09] |
頁次 | 頁87-92 |
分類號 | 416.245 |
關鍵詞 | 骨盆腔復發; 大腸直腸癌; Pelvic recurrence; Colorectal cancer; |
語文 | 英文(English) |
中文摘要 | 目的:大腸直腸癌手術後之骨盆腔復發是一個重大的難題。手術切除是達到根治唯一的希望。然而,只有少數的復發腫瘤可被成功的切除。本研究在於評估單一外科醫師在骨盆腔復發大腸直腸癌的手術治療上之經驗。方法:自1988年7月至2010年12月,共120位病患接受同一位外科醫師對骨盆腔復發大腸直腸癌之手術治療。在這些病人中,包含56位男性及64位女性,年齡介於30至85歲之間(平均年齡58.6歲),115人之腫瘤病理組織型態為腺癌,首次手術切除原發腫瘤之術式包含107例前位直腸切除術及13例腹部會陰切除手術。本研究之排除條件為:病患有遠端轉移,病患接受非手術治療以及病患有不同發性的腫瘤。結果:對於骨盆腔復發大腸直腸癌的120例手術治療病患中,16例接受腹部會陰切除手術,8例接受前位直腸切除術,17例接受腫瘤切除,7例接受部分小腸切除,12例接受腸道繞道手術,43例接受大腸造廔術,13例接受迴腸造廔術,另有4例僅剖腹探查。手術相關死亡率為9.02%(11/120)。17例手術為治癒性手術;有14個病患存活超過五年。結論:骨盆腔復發大腸直腸癌之手術治療可延長病患的生命,甚至提供治癒的機會,但即使最根除性的手術切除亦鮮少治癒病患,手術以外的治療僅能在無法手術的情況時供症狀緩解之用。 |
英文摘要 | Purpose. The recurrence of cancer in the pelvis is a serious issue when it occurs after a resection for colorectal cancer. Resections are the most effective treatment; however, these resections are rarely successful. This study evaluated a surgeon's experience of surgical treatment of pelvic cancer recurrence.Materials and Methods. From July 1988 to December 2010, a total of 120 patients with pelvic recurrence of colorectal cancer were managed by a single surgeon (TCH). Among the patients, 56 were men and 64 were women. Their ages ranged from 30 to 85 years (an average age of 58.6 years). One hundred and fifteen patients had adenocarcinomas. The initial surgeries for primary cancer were 107 anterior resections (ARs) and 13 abdominoperineal resections (APRs). The study excluded patients with distant metastasis, patients that received non-surgical treatment, and patients with metachronous malignancies.Results. Surgical procedures for pelvic recurrences included 16 APRs, eight ARs, 17 tumor resections, seven bowel resections, 12 intestinal bypasses, 43 colostomies, 13 ileostomies, and 4 laparotomies. The operative mortality was 9.02% (11/120). Seventeen operations were considered curative resections; however, only 14 patients lived over five years.Conclusion. Surgical resection may prolong life and offer a chance of a cure in particular cases. However, even a radical resection rarely cures the disease. Other surgical alternatives are recommended for palliation when possible. |
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