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目的 评价不同操作步骤的大肠癌根治手术对大肠癌肝转移的影响。方法 将 1990～ 1995年收治的 80例大肠癌患者随机分成两组 :A组手术采用不接触隔离技术 (Non Touch Isolation Technic)即 :首先隔离受累结肠的肠腔 ,由根部结扎、切断供应受累结肠的淋巴血管蒂 ,最后才将受累肠段和相应的肠系膜整快切除 ;B组则直接分离出肿瘤肠段 ,将此段肠管及相应系膜直接切除 ,不隔离肠腔、不由根部处理淋巴血管蒂。 80例患者中 ,A组 31例 ,B组 49例。结果 两组患者肿瘤大体类型、组织学分类、恶性程度和肿瘤分期上均无统计学差异。A组 3年肝转移 6例 (6 / 31) ;B组 3年肝转移 15例 (15 / 49)。两组相比差异显著 (P<0 .0 5 )。结论 手术操作步骤在大肠癌根治性手术中占有重要地位 ,不接触隔离技术能明显降低肝转移率 ,值得推广应用。
Objective To evaluate the effect of radical resection of colorectal cancer on liver metastasis of colorectal cancer with different procedures. Methods Eighty patients with colorectal cancer who were admitted from 1990 to 1995 were randomly divided into two groups: Non-contact Isolation Technic was used in group A. The first step was to isolate the intestinal lumen of the affected colon, and the roots were ligated and cut off. The lymphatic vascular pedicle finally excised the affected bowel segment and the corresponding mesentery; the B group was directly isolated from the tumor intestine, and the intestinal and corresponding mesentery were directly resected. The intestine was not isolated and the lymph vessels were not treated by the root. Di. Of the 80 patients, 31 were in group A and 49 in group B. Results There was no statistical difference in the general tumor type, histological classification, malignancy and tumor stage between the two groups. In group A, three years of liver metastasis occurred in 6 cases (6/31); in group B, 3 years of liver metastasis occurred in 15 cases (15/49). The difference between the two groups was significant (P<0.05). Conclusion The operation procedure plays an important role in the radical surgery of colorectal cancer. No contact with isolation technology can significantly reduce the liver metastasis rate. It is worthy of popularization and application.