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目的:探讨多原发性结直肠癌(multipleprimarycolorectalcarcinoma,MPCC)的临床特点、手术治疗及预后,以期提高对该病的诊治效果。方法:回顾性分析43例MPCC患者的临床资料、病理特点、手术类型以及预后。结果:MPCC占同期收治结直肠癌总数的的7·6%(43/563),其中同时性多原发癌(synchronouscarcinoma,SC)32例,共计67个癌灶;异时性多原发癌(metachronouscarcinoma,MC)11例,共计24个癌灶。癌灶间相距小于10cm者28例,大于10cm者15例,癌灶位于同一根治性切除范围内26例,不同切除范围内17例。32例SC患者中,29例施行根治性切除术,2例行结肠造口术,1例确诊后放弃手术。11例MC患者中,9例先后共施行20例次手术,另2例结肠造口术。结论:在诊治结直肠癌时要考虑到MPCC可能,避免漏诊和误诊,一经明确诊断MPCC,应尽量手术切除,在遵循最大限度地切除癌肿的前提下,兼顾保留脏器功能和维护术后生存质量。
Objective: To investigate the clinical features, surgical treatment and prognosis of multiple primary colorectal cancer (MPCC) in order to improve the diagnosis and treatment of this disease. Methods: Retrospective analysis of 43 cases of MPCC patients with clinical data, pathological features, type of surgery and prognosis. Results: MPCC accounted for 7.6% (43/563) of the total colorectal cancer in the same period, of which 32 cases were synchronous carcinomatous (SC) (metachronouscarcinoma, MC) in 11 cases, a total of 24 foci. 28 cases were less than 10 cm away from the tumor, 15 were more than 10 cm. 26 cases were located in the same radical resection and 17 cases were in different resection. Of the 32 SC patients, 29 underwent radical resection, 2 underwent colostomy, and 1 gave up surgery after diagnosis. Eleven patients with MC, 9 cases were performed a total of 20 cases of secondary surgery, the other 2 cases of colostomy. Conclusion: MPCC should be considered in the diagnosis and treatment of colorectal cancer to avoid misdiagnosis and misdiagnosis. Once the diagnosis of MPCC is correct, resection should be performed as much as possible. Under the premise of maximal removal of cancer, both organ preservation and postoperative maintenance Quality of Life.