| Objective: At present,the morbidity of colorectal cancer is increasing year by year,about 20% of the patients with colorectal cancer in primary tumors in progression of liver metastasis after radical surgery treatment,another 20% of colorectal cancer patients have occurred liver metastases at diagnosis,RO surgery of metastases resection and primary focal liver metastatic colorectal cancer treatment is a best way.According to the latest ?Guidelines for the diagnosis and Comprehensive treatment of Hepatic Metastasis from Colorectal Cancer?(2016),there are two common operative method for hepatic metastasis of colorectal cancer : primary colorectal cancer and secondary phase resection of hepatic metastases(hereinafter referred to first bowel and after liver surgery)and primary resection of primary colorectal cancer and liver metastases(hereinafter referred to as simultaneous surgery).At present,it is still controversial to choose surgical resection or surgical resection for the initial resection of colorectal cancer at the same time.Of this study is aimed at first bowel liver surgery and surgical excision is applied to the same period after a recent curative effect in the treatment of colorectal liver metastases,forward curative effect and security analysis,based on this provides the theoretical basis in the treatment of colorectal liver metastases.Methods: 142 cases with synchronous colorectal liver metastases,from June 2008 to June 2015 in three qualified AAA class hospitals,and with regular and long term follow-up,were retrospectively analyzed.Patients were divided into 2 groups,including bowel before liver resection in 76 cases,66 cases surgical removal of the same period,the former set after the first bowel liver group,which is set to the same period surgical group;To compare the operation time,length of stay,intraoperative blood loss,postoperative complication rate and survival rate of 1,2,3,4 and 5 years and disease free survival after the initial resectable colorectal cancer.Results: The mean operation time of the 66 patients with colorectal cancer in the operation group was(231.53 ± 20.96)min,and the mean operation time was(270.16 ± 24.31)for the 76 patients with colorectal cancer.The mean operative time of the operation group was significantly shorter than that of the first bowel group,and the difference between the two groups was statistically significant(P < 0.05).The mean length of hospitalization of 66 patients with colorectal cancer in the operation group was(17.34.53 ±2.36)d,and the average length of hospital stay in 76 patients with colorectal cancer was(20.07 ± 3.19)d.The average length of hospital stay in the operation group was significantly shorter than that in the first bowel group,and the difference between the two groups was statistically significant(P < 0.05).The average intraoperative blood loss of 66 patients with colorectal cancer in the operation group was(464.85 ±121.61),and the mean operation time was(568.37 ± 107.75)in 76 patients with colorectal cancer.The average intraoperative blood loss in the operation group was significantly lower than that in the first bowel group,and the difference between the two groups was statistically significant(P< 0.05).Over the same period surgical group of 66 cases of patients with liver metastases from colorectal cancer,3 cases of postoperative pulmonary infection,1 case of postoperative anastomotic fistula,4 cases of postoperative incision infection,1 case of merging two and two or more complications,the incidence of postoperative complications was 12.12%(8/66);Liver after intestinal first group of 76 cases of patients with liver metastases from colorectal cancer,4 cases of postoperative pulmonary infection,3 cases of postoperative anastomotic fistula,2 cases of postoperative incision infection,1 case of merging two and more than two kinds of complications,the incidence of postoperative complications was 11.84%(9/76);There was no difference in the incidence of postoperative complications between the two groups(P>0.05).Over the same period surgical group 66 cases of patients with liver metastases from colorectal cancer after 1 year,2 years,3 years,4 years,5 years survival rate was 92.42%(61/66),56.06%(37/66),45.45%(30/66),33.33%(22/66),21.21%(14/66),liver after intestinal first group of 76 cases of patients with liver metastases from colorectal cancer after 1 year,2 years,3 years,4 years,5 years survival rate was 90.79%(69/76),57.89%(44/76)and 43.02(37/76),31.58%(24/76),19.74%(15/76);There was no difference in the survival rate between the two groups after 1,2,3,4 and 5 years after surgery,with no statistical significance(P > 0.05).At the same time,there was no difference disease free survival with no statistical significance(P > 0.05).Conclusion: 1 During the same period,the operation of liver metastasis in colorectal cancer has high safety and efficacy.2 The same period compared with the first bowel after liver surgery,surgical treatment of patients with colorectal cancer liver metastases can be further shorten the operation time,hospitalization time,still can reduce intraoperative blood loss,and the forward curative effect and the intestinal after liver surgery.3 During the same period,surgery is applied to the liver metastasis of colorectal cancer,so that patients can avoid two surgical strike,relieve their psychological burden,and have social economic benefits,as long as the indication was measured seriously,which is worthy of popularization and application. |
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