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中华腔镜外科杂志(电子版) ›› 2021, Vol. 14 ›› Issue (04) : 241 -244. doi: 10.3877/cma.j.issn.1674-6899.2021.04.012

所属专题: 经典病例

病例报告

腹腔镜手术治疗结肠癌肝转移并盆腔转移一例
向俊西1, 杨魁2, 王光辉2, 李龙3, 张月浪4, 吴胤英5, 杨威1, 佘军军2, 刘青光1, 姚英民1, 郭成1,()   
  1. 1. 710061 西安交通大学第一附属医院肝胆外科
    2. 710061 西安交通大学第一附属医院胃肠外科
    3. 710061 西安交通大学第一附属医院妇科
    4. 710061 西安交通大学第一附属医院影像科
    5. 710061 西安交通大学第一附属医院肿瘤内科
  • 收稿日期:2021-07-28 出版日期:2021-10-08
  • 通信作者: 郭成

Laparoscopic surgery for colon cancer liver metastasis and pelvic metastasis: a case report

Junxi Xiang1, Kui Yang2, Guanghui Wang2, Long Li3, Yuelang Zhang4, Yinying Wu5, Wei Yang1, Junjun She2, Qingguang Liu1, Yingmin Yao1, Cheng Guo1,()   

  1. 1. First Affiliated Hospital of Xi′an Jiaotong University, Department of; Hepatobiliary Surgery, Xi′an 710061, China
    2. Gastrointestinal Surgery, Xi′an 710061, China
    3. Gynaecology, Xi′an 710061, China
    4. Radiology, Xi′an 710061, China
    5. Oncology, Xi′an 710061, China
  • Received:2021-07-28 Published:2021-10-08
  • Corresponding author: Cheng Guo
引用本文:

向俊西, 杨魁, 王光辉, 李龙, 张月浪, 吴胤英, 杨威, 佘军军, 刘青光, 姚英民, 郭成. 腹腔镜手术治疗结肠癌肝转移并盆腔转移一例[J/OL]. 中华腔镜外科杂志(电子版), 2021, 14(04): 241-244.

Junxi Xiang, Kui Yang, Guanghui Wang, Long Li, Yuelang Zhang, Yinying Wu, Wei Yang, Junjun She, Qingguang Liu, Yingmin Yao, Cheng Guo. Laparoscopic surgery for colon cancer liver metastasis and pelvic metastasis: a case report[J/OL]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2021, 14(04): 241-244.

目的

总结腹腔镜同期手术治疗结肠癌肝转移并盆腔转移的技术体会,探讨其在治疗此类疾病中的安全性及可行性。

方法

回顾性分析2021年6月西安交通大学第一附属医院1例结肠癌肝转移并盆腔转移患者的临床资料及诊疗过程。

结果

患者接受同期腹腔镜右半结肠切除、肝转移癌切除、全子宫及双侧附件切除,均顺利实现R0切除,总手术时间330 min,术中出血量100 ml,术后恢复顺利,辅助腹腔热灌注化学药物治疗。病理结果提示:结肠溃疡型中分化腺癌,侵及子宫肌壁深肌层及双侧卵巢组织、宫颈,肝组织内有中分化腺癌浸润,肠周(2/30个)淋巴结有癌转移。患者术后1个月复查腹部CT,肿瘤标志物未见明显异常,目前继续严密随访中。

结论

腹腔镜同期手术对于结肠癌肝转移并盆腔转移的治疗是安全、可行的,同时具有创伤小、恢复快、切口美观等优点,多学科诊疗模式对于提高患者临床获益具有重要作用,值得推广。

Objective

To summarize the experience of laparoscopic concurrent surgery in the treatment of colon cancer liver metastasis and pelvic metastasis, and to explore its safety and feasibility in the treatment process.

Methods

A retrospective analysis of the clinical data and diagnosis and treatment process of a patient with liver metastasis from colon cancer and pelvic metastasis in the First Affiliated Hospital of Xi′an Jiaotong University in Jun. 2021.

Results

The patient received simultaneous laparoscopic resection of the right colon for liver metastatic cancer, complete hysterectomy and bilateral adnexectomy, and R0 resection was successfully achieved. The total operative time was 330 min, and the bleeding was 100 ml. Peritoneal hyperthermic perfusion chemotherapy was assisted. Pathological results showed that colonic ulcerative moderately differentiated adenocarcinoma invaded the deep myometrium of the uterine wall and bilateral ovarian cervix, infiltrated in liver tissue, and metastatic in periintestinal lymph nodes (2/30). The abdominal CT and tumor markers showed no abnormalities one month after the operation. At present, the patient is continuing to follow up closely.

Conclusions

Simultaneous laparoscopic surgery is safe and feasible for the treatment of colon cancer liver metastases and pelvic metastases. It also has the advantages of less trauma, fast recovery, and beautiful incisions. The MDT mode plays an important role in improving the clinical benefits of patients and is worthy of promotion.

图1 术前腹腔、盆腔CT
图2 术中探查及主要操作步骤
图3 结肠癌灶病理检查 (HE, 100×)
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