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目的探讨结直肠癌合并肝脏转移经导管动脉灌注及栓塞治疗的价值。资料与方法35例结直肠癌合并肝脏转移患者,行结直肠肿瘤供血动脉插管灌注化疗和/或栓塞术,同时对肝脏转移瘤行动脉插管灌注化疗栓塞术。其中介入治疗后1～3个月23例患者行结直肠肿瘤外科手术切除,6例肝脏单发转移癌行外科手术切除。结果所有病例术后1～3个月随访复查CT,结直肠肿块显效11例,有效22例,无效2例;肝脏转移灶显效20例,有效12例,无效3例。23例外科手术切除肿瘤顺利,术中出血300～1500ml,术后病理提示肿瘤坏死明显,可见纤维组织增生和炎性细胞浸润。6例肝脏转移瘤外科切除,术后病理提示1例未见癌细胞,其余5例可见少量癌细胞,坏死明显。结论经导管动脉灌注及栓塞治疗结直肠癌合并肝脏转移疗效显著,值得推广。
Objective To investigate the value of transcatheter arterial infusion and embolization of colorectal cancer with liver metastasis. Materials and Methods 35 cases of colorectal cancer with liver metastasis, colorectal tumor feeding artery infusion chemotherapy and / or embolization, at the same time, liver metastases arterial intubation chemotherapy embolization. Twenty-three patients underwent surgical resection of colorectal tumor 1 to 3 months after interventional therapy, and 6 patients with solitary liver metastasis underwent surgical resection. Results All cases were followed up for 1 to 3 months after operation. CT was performed in 11 cases of colorectal mass, effective in 22 cases and ineffective in 2 cases. Liver metastases were effective in 20 cases, effective in 12 cases and ineffective in 3 cases. 23 cases of surgical resection of the tumor smoothly, intraoperative bleeding 300 ~ 1500ml, postoperative pathology showed tumor necrosis obvious fibrous tissue proliferation and inflammatory cell infiltration. Six cases of liver metastases were surgically resected. Postoperative pathology showed that one case had no cancer cells and the other five cases showed a small amount of cancer cells with obvious necrosis. Conclusion Transcatheter arterial perfusion and embolization in the treatment of colorectal cancer with liver metastasis is significant and worth promoting.