We evaluated the surgical results in 32 patients with liver metastasis from colorectal carcinoma. Twenty four patients had 1-3 metastatic hepatic nodules and 20 patients had synchronous hepatic metastasis. Liver resection was carried out simultaneously with radical resection of the primary tumour in 15 patients, 5 patients experienced resection 2 to 4 weeks later. Liver and primary tumour were resected as a whole in 5 patients with infiltrating metastasis from colonic carcinoma.Other operative types included atypical resections, left lateral lobectom and right posterior lobectomy, and right hemihepatactomy, right trilobectomy.Hepatic metastasis were all documented by pathology. The 3year and 5year survival rate were 37.5% and 25.0%, with no operative death. The authors believed that the number of metastasis is the most important factor influencing the surgical result, and liver resection is an effective form of treatment for patients with resectable liver metastasis from colorectal carcinoma, but the type of surgery shall be choosed reasonably.
One hundred and twenty eight patients with intestinal obstruction due to cancer of left lemicolon are presented. In this series 71 patients suffered from partial intestinal obstruction and 57 patients from complete obstruction, the latter were in later Dukes stages, with lesser resectability of the tumor and higher mortality. The transition from partial obstruction to complete obstruction takes a slow course. Purgatives and coarse fibered food should not be given to the patients with partial obstruction, or else will induce acute obstruction. Several types of operation for partial and complete obstruction are discussed. Methods and results of intraoperative colonic irrigation are presented. The authors believe that intraoperative colonic irrigation is a good emergency management for cancer obstruction of the left colon. Complication of this disease are also discussed.
In this series of 30 patients of intestinal tuberculosis, diagnosis was made by the typical appearance of caseous change of intestines and mesectery, pathological evidence of endoscopic biopsy or biopsy at operation. In 16 patients preoperative chest X-ray showed pulmonary TB lesion. X-ray gastrointestinal exmaination was performed in 24 patients and 20 patients underwent clonic endoscopy,both of them showed abnormal but nonspecific manifestation.Three patients underwent partial resection of small intestine, 20 patients right hemicolectomy, 3 patients subtotal colectomy, 1 patient abdominal resection of rectum, 2 patients partial resection of small bowel and right hemicolectomy and 1 patient partial resection of ileum and right hemicolon and part of rectum. It is believed that intestinal tuberculosis could manifest itself in segmental changes and bridge of mucosa, and should differented from Crohn’s disease. Resection and anastomosis after exploration and postoperative antituberculosis therapy is necssary.