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1990年3月～1993年8月作者为46例结直肠癌术后复发进行再次手术。再次手术与初手术相隔时间为6～80个月,平均34.4个月。其中单纯局部复发占34.78%,单纯远处转移13.04%,局部复发伴远处转移52.18%。再次手术能切除病变者36例,切除率78.26%。切除后存活时间5～41个月,中位存活17个月,26例至今尚存活。手术死亡2例,手术死亡率4.35%,其中1例死亡与手术无关。作者指出早期发现复发对手术处理和预后都有重要意义。一旦发现局限的单发病变,首选手术治疗。为提高再次手术的切除率,应辅以术前放疗和化疗。在复发病变切除后,继续进行化疗和免疫治疗。总之,对术后复发病例宜以积极态度采用综合治疗,以期达到较好的效果。
From March 1990 to August 1993, the authors performed reoperation for recurrence of 46 colorectal cancers. The interval between reoperation and initial surgery was 6 to 80 months, with an average of 34.4 months. Among them, simple local recurrence accounted for 34.78%, simple distant metastasis was 13.04%, and local recurrence with distant metastasis was 52.18%. After surgery, 36 cases were resected and the resection rate was 78.26%. The survival time was 5 to 41 months after resection, and the median survival was 17 months. 26 cases survived to this day. Two patients died of operative mortality and the surgical mortality rate was 4.35%. One of the deaths was not related to surgery. The authors pointed out that early detection of recurrence has important implications for surgical management and prognosis. Once a limited single lesion is found, surgical treatment is preferred. In order to improve the resection rate of reoperation, preoperative radiotherapy and chemotherapy should be supplemented. After resection of recurrent lesions, chemotherapy and immunotherapy are continued. In short, it is advisable to adopt comprehensive treatment with a positive attitude towards postoperative recurrences in order to achieve better results.