中国实用外科杂志

中国实用外科杂志

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结直肠癌肝转移的手术治疗决策

许剑民，林    奇   

  1. 复旦大学附属中山医院普外科  复旦大学普通外科研究所  复旦大学大肠癌诊治中心，上海 200032
  • 出版日期:2016-04-01 发布日期:2016-03-29

  • Online:2016-04-01 Published:2016-03-29

摘要：

肝转移是结直肠癌病人死亡的主要原因，手术是治疗结直肠癌肝转移最有效的也是惟一有可能治愈的手段。然而，如何制定精准的个体化治疗方案（包括化疗和手术的最佳时机及方式）一直存在争议。因此，如何通过多学科综合治疗协作组对结直肠癌肝转移病人及其术前检查结果进行全面评估，针对不同的治疗目标，将病人分为不同组别，明确各组不同的治疗目的，为病人选择合理的化疗和靶向药物治疗方案，确定最佳手术时机（是同期切除还是分期切除）和手术方式（切除范围、微创或开腹手术）是提高结直肠癌肝转移病人预后的关键。

关键词: 结直肠癌肝转移, 手术治疗

Abstract:

Surgical treatment strategy and option for colorectal liver metastases        XU Jian-min, LIN Qi. Department of General Surgery, Zhongshan Hospital, Fudan University; Institute of General Surgery, Fudan University; Colorectal Cancer Research Center, Fudan University, Shanghai 200032, China
Corresponding author：XU Jian-min，E-mail：xujmin@a1iyun.com
Abstract    The development of liver metastasis is the leading causes of death from colorectal cancer. A subset of patients with colorectal liver metastasis (CRLM) can benefit from radical surgery and may even achieve a cure. However, how to select a suitable therapeutic regimen including the timing and method of chemotherapy and surgery is still under controversy. Therefore, how to conduct a comprehensive assessment on the preoperative examination results of patients with CRLM through the multidisciplinary team,according to different treatment aim and different clinically defined groups, clear the aim of treatment for each different group, choose reasonable chemotherapy and targeted therapy for the patient, and determine the optimal timing of surgical resection is the key point in improving the prognosis of patients with CRLM.

Key words: colorectal liver metastasis, surgical treatment