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目的：总结和分析大肠癌肝转移的早期诊断和手术治疗。方法：通过对大肠癌肝转移病例进行回顾性分析．并结合文献对有关大肠癌的早期诊断及外科手术切除治疗等相关问题进行讨论。结果：①１８例中，依靠ＣＴ、“Ｂ”超及ＣＥＡ定量检测获得诊断者１０例，术中探查获得诊断者８例。②手术方式分为肝段切除、肝楔形切除及肿瘤剜出术。③１８例中生存５年者２例，生存４年者３例．生存３年者５例，生存２年者５例，生存１年者３例。①无手术死亡病例，术中肝后段下腔静脉大出血１例，术后切口脂肪液化１例。结论：早期大肠癌肝转移的诊断中要依靠术中仔细对肝脏的探查，“Ｂ”超、ＣＴ等影像学随访及ＣＥＡ的定量随访监测。目前手术治疗是大肠癌肝转移最有效的治疗方法．主流术式应为不规则肝切除，切缘距肿瘤＞１．０ ｃｍ为大肠癌肝转移的根治性切除术。肿瘤切除术后大肠癌肝转移病例能获得良好的结果。
Objective: To summarize and analyze the early diagnosis and surgical treatment of liver metastases of colorectal cancer. Methods: Retrospective analysis of liver metastases of colorectal cancer. Combined with the literature, we discussed the related issues of early diagnosis of colorectal cancer and surgical resection treatment. RESULTS: Of the 118 cases, 10 cases were diagnosed by CT, “B” ultrasonography, and CEA quantitative examination. 8 cases were diagnosed by intraoperative exploration. 2 surgical methods are divided into liver segment resection, liver wedge resection and tumor resection. 318 cases survived 5 years in 2 cases, 4 years survived in 3 cases. There were 5 cases who survived for 3 years, 5 cases survived for 2 years, and 3 cases survived for 1 year. 1 There were no operative deaths. Intraoperative hepatic inferior vena cava hemorrhage occurred in 1 case. Liposuction fat liquefaction occurred in 1 patient. Conclusion: The diagnosis of early colorectal liver metastases depends on careful exploration of the liver during operation, radiological follow-up of “B” ultrasound, CT, and quantitative follow-up monitoring of CEA. At present, surgical treatment is the most effective treatment for colorectal liver metastasis. The main surgical technique should be an irregular hepatectomy with a margin of >1.0 cm from the tumor as a radical resection of liver metastases from colorectal cancer. Cases of colorectal liver metastases after tumor resection can achieve good results.