切换至 "中华医学电子期刊资源库"

中华结直肠疾病电子杂志 ›› 2025, Vol. 14 ›› Issue (02) : 114 -123. doi: 10.3877/cma.j.issn.2095-3224.2025.02.002

指南与共识

河南省直肠癌基层诊疗规范专家共识(2024)
河南省医师协会结直肠肛门外科医师分会   
  • 收稿日期:2021-12-18 出版日期:2025-04-25

Expert consensus on the standardized diagnosis and treatment of rectal cancer in primary medical service institutions in He'nan Province (2024 Edition)

Provincial Medical Doctor Association,the Committee of Colorectal He'nan   

  • Received:2021-12-18 Published:2025-04-25
引用本文:

河南省医师协会结直肠肛门外科医师分会. 河南省直肠癌基层诊疗规范专家共识(2024)[J/OL]. 中华结直肠疾病电子杂志, 2025, 14(02): 114-123.

Provincial Medical Doctor Association,the Committee of Colorectal He'nan. Expert consensus on the standardized diagnosis and treatment of rectal cancer in primary medical service institutions in He'nan Province (2024 Edition)[J/OL]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2025, 14(02): 114-123.

本共识围绕直肠癌的基层诊疗规范进行总结,旨在为基层医疗机构提供科学、规范的诊疗指导。内容涵盖直肠癌的流行病学特点、早期筛查、临床表现、诊断标准及评估方法,同时对治疗手段包括手术、放疗、化疗及靶向治疗进行了阐述。共识强调了基层医务工作者在直肠癌防治中的关键作用,提出了诊疗流程及随访等管理建议,旨在提高基层直肠癌的早期诊断率及治疗效果,提高患者生存及改善患者生活质量。

This consensus focuses on summarizing the standardized diagnosis and treatment guidelines for rectal cancer in primary medical,aiming to provide scientific and standardized guidance for primary medical service institutions. The content covers the epidemiological characteristics,early screening,clinical manifestations,diagnostic criteria,and evaluation methods of rectal cancer. It also elaborates on treatment approaches,including surgery,radiotherapy,chemotherapy,and targeted therapy. The consensus highlights the critical role of primary medical workers in rectal cancer prevention and treatment,proposing diagnostic pathways and follow-up management recommendations. The goal is to improve the early diagnosis rate and treatment outcomes of rectal cancer at the primary medical service institutions,reduce patient mortality,and enhance patients' quality of life.

《河南省直肠癌基层诊疗规范专家共识(2024)》编委会名单
名誉组长
袁维堂 郑州大学第一附属医院
组长
胡军红 郑州大学第一附属医院
副组长
赫 鹏 新乡医学院第一附属医院
李 震 郑州大学第一附属医院
刘德纯 河南科技大学第一附属医院
孙振强 郑州大学第一附属医院
张 超 河南省人民医院
张春旭 中国人民解放军联勤保障部队第九八八医院
庄 競 河南省肿瘤医院
执笔人
胡晟云、王玉行、张振飞
委员
白军伟 河南省人民医院
白 杨 郑州大学第一附属医院
蔡郁辉 濮阳市人民医院
高晓庆 郑州大学第一附属医院
高宗跃 河南省中医院(河南中医药大学第二附属医院)
侯超峰 郑州市中心医院
胡晟云 郑州大学第一附属医院
华 龙 河南大学淮河医院
皇甫深强 河南大学第一附属医院
靳水玲 郑州大学第一附属医院
李 昂 南阳医学高等专科学校第一附属医院
李朝辉 洛阳市中心医院
李国宾 郑州大学第一附属医院
李国强 信阳市中心医院
李相臣 新乡市中心医院
连加玉 周口市中心医院
刘世举 河南中医药大学第三附属医院
乔超峰 焦作市第二人民医院
秦瑞霞 郑州大学第一附属医院
唐红娜 河南大学淮河医院
王晨宇 河南大学淮河医院
王金榜 河南省肿瘤医院
王玉行 郑州大学第一附属医院
于秀芝 驻马店市中心医院
张传林 开封市第三人民医院
张军杰 海口市人民医院
张 威 郑州市大肠肛门病医院(河南省中医消化病医院)
张振飞 郑州大学第一附属医院
张志永 郑州大学第一附属医院
郑英斌 郑州大学第二附属医院
周全博 郑州大学第一附属医院
朱鸿波 开封市中心医院
[1]
杨明,张金珠,王锡山. 全国肿瘤登记中心发布的2013年至2022年结直肠癌流行数据趋势解读[J/OL]. 中华结直肠疾病电子杂志,2024,13(3):177-181.Yang M,Zhang JZ,Wang XS. Interpretation of colorectal cancer prevalence trend data from 2013 to 2022 released by the National Tumor Registry[J/OL]. Chin J Colorec Dis(Electronic Edition),2024,13(3):177-181.
[2]
张建功,刘茵,陈琼,等. 2018年河南省结直肠癌流行现状及2010~2018年流行趋势分析[J]. 郑州大学学报(医学版),2022,57(4):482-486.
[3]
王福奇,周全博,孙振强,等. 河南地区结直肠癌发病特征分析[J].中国全科医学,2018,21(3):269-273.Wang FQ,Zhou QB,Sun ZQ,et al. Analysis of the incidence characteristics of colorectal cancer in He'nan region[J]. Chinese General Practice,2018,21(3):269-273.
[4]
徐春光,董云宁. 河南省乡村医疗卫生体系建设:现状、问题与对策[J]. 农村·农业·农民,2024,(16):36-38.Xu CG,Dong YN. Construction of rural healthcare system in He'nan province:current situation,problems,and countermeasures[J]. Rural Areas,Agriculture,and Farmers,2024,(16):36-38.
[5]
姚宏伟,孙应实,张晓燕,等. 结直肠癌多学科综合治疗协作组诊疗模式中国专家共识(2023版)[J]. 中国实用外科杂志,2024,44(1):1-16.Yao HW,Sun YS,Zhang XY,et al. Multidisciplinary team(MDT)diagnosis and treatment model for colorectal cancer:Chinese experts consensus(2023 edition)[J]. Chinese Journal of Practical Surgery,2024,44(1):1-16.
[6]
中华医学会肿瘤学分会早诊早治学组. 中国结直肠癌早诊早治专家共识(2023版)[J]. 中华医学杂志,2023,103(48):3896-3908.Early Diagnosis and Treatment Working Group of the Oncology Branch of the Chinese Medical Association. Expert consensus on early diagnosis and treatment of colorectal cancer in China (2023 Edition)[J]. Chinese Journal of General Surgery (Electronic Edition),2023,103(48):3896-3908.
[7]
冷晓旭,房静远. 粪便标志物DNA和RNA筛查结直肠癌特性分析[J]. 中华医学杂志,2020,100(42):3373-3336.Leng XX,Fang JY. Analysis of characteristics of fecal DNA and RNA markers for screening colorectal cancer[J]. National Medical Journal of China,2020,100(42):3373-3376.
[8]
Doubeni CA,Major JM,Laiyemo AO,et al. Contribution of behavioral risk factors and obesity to socioeconomic differences in colorectal cancer incidence[J]. J Natl Cancer Inst,2012,104(18):1353-1362.
[9]
Zhang X,Theodoratou E,Li X,et al. Genetically predicted physical activity levels are associated with lower colorectal cancer risk:a Mendelian randomisation study[J]. Br J Cancer,2021,124(7):1330-1338.
[10]
郭兰伟,郑黎阳,陈琼,等. 河南省城市地区结肠镜筛查人群结直肠进展期肿瘤检出情况及其影响因素分析[J]. 中华肿瘤杂志,2024,46(8):794-800.Guo LW,Zheng LY,Chen Q,et al. Detection of advanced colorectal tumors in a colonoscopy screening population in urban areas of He'nan province and analysis of influencing factors [J]. Chin J Oncol,2024,46(8):794-800.
[11]
蔡香然,孟悛非,陈棣华,等. 钡灌肠和CT及MRI对结直肠癌诊断的比较影像学研究[J]. 中华胃肠外科杂志,2005,8(1):46-49.Cai XR,Meng QF,Chen DH,et al. Comparative imaging study of barium enema,CT,and MRI in the diagnosis of colorectal cancer [J].Chin J Gastrointest Surg,2005,8(1):46-49.
[12]
王屹. 结直肠癌肝转移瘤影像诊断[J]. 中华肝胆外科杂志,2020,26(7):500-502.Wang Y. Imaging diagnosis of hepatic metastases from colorectal cancer[J]. Chinese Journal of Hepatobiliary Surgery,2020,26(7):500-502.
[13]
Al-Sukhni E,Milot L,Fruitman M,et al. Diagnostic accuracy of MRI for assessment of T category,lymph node metastases,and circumferential resection margin involvement in patients with rectal cancer:a systematic review and meta-analysis[J]. Ann Surg Oncol,2012,19(7):2212-2223.
[14]
Smith NJ,Barbachano Y,Norman AR,et al. Prognostic significance of magnetic resonance imaging-detected extramural vascular invasion in rectal cancer[J]. Br J Surg,2008,95(2):229-236.
[15]
Kaur H,Choi H,You YN,et al. MR imaging for preoperative evaluation of primary rectal cancer:practical considerations[J].Radiographics,2012,32(2):389-409.
[16]
Zech CJ,Korpraphong P,Huppertz A,et al. Randomized multicentre trial of gadoxetic acid-enhanced MRI versus conventional MRI or CT in the staging of colorectal cancer liver metastases[J]. Br J Surg,2014,101(6):613-621.
[17]
Scharitzer M,Ba-Ssalamah A,Ringl H,et al. Preoperative evaluation of colorectal liver metastases:comparison between gadoxetic acid-enhanced 3.0-T MRI and contrast-enhanced MDCT with histopathological correlation[J]. Eur Radiol,2013,23(8):2187-2196.
[18]
Chen J,Yan Q,Sun J,et al. Microsatellite status detection of colorectal cancer:evaluation of inconsistency between PCR and IHC[J]. Journal of Cancer,2023,14(7):1132-1140.
[19]
朱惠,蔡继东,李溟涵,等. 结肠直肠癌错配修复蛋白表达与微卫星稳定性的一致性分析[J]. 外科理论与实践,2024,29(2):148-155.Zhu H,Cai JD,Li MG,et al. Consistency analysis of mismatch repair protein expression and microsatellite instability in colorectal cancer[J].Journal of Surgical Concepts & Practice,2024,29(2):148-155.
[20]
André T,Shiu KK,Kim TW,et al. Pembrolizumab versus chemotherapy in microsatellite instability-high or mismatch repairdeficient metastatic colorectal cancer:5-year follow-up from the randomized phase 3 KEYNOTE-177 study[J]. Ann Oncol,2025,36(3):277-284.
[21]
Diaz LA,Shiu KK,Kim TW,et al. Pembrolizumab versus chemotherapy for microsatellite instability-high or mismatch repairdeficient metastatic colorectal cancer (KEYNOTE-177):final analysis of a randomised,open-label,phase 3 study[J]. The Lancet Oncology,2022,23(5):659-670.
[22]
张剑威,邓艳红. 微卫星稳定或错配修复正常结直肠癌的新辅助免疫治疗[J]. 中华胃肠外科杂志,2022,25(3):193-198.Zhang JW,Deng YH. Neoadjuvant immunotherapy for microsatellite stable or mismatch repair proficient colorectal cancer[J]. Chin J Gastrointest Surg,2022,25(3):193-198.
[23]
Stamos MJ,Murrell Z. Management of early rectal T1 and T2 cancers[J]. Clin Cancer Res,2007,13(22 Pt 2):6885s-6889s.
[24]
Perez RO,Habr-Gama A,São Julião GP,et al. Transanal endoscopic microsurgery (TEM) following neoadjuvant chemoradiation for rectal cancer:outcomes of salvage resection for local recurrence[J]. Ann Surg Oncol,2016,23(4):1143-1148.
[25]
邱小原,林国乐,牛备战,等. TEM技术在中低位直肠癌个性化治疗中的应用 [J]. 中华腔镜外科杂志(电子版),2024,17(4):210-217.Qiu XY,Lin GL,Niu BZ,et al. Application of transanal endoscopic microsurgery (TEM) in personalized treatment of middle and low rectal cancer[J]. Chinese Journal of Laparoscopic Surgery (Electronic Edition),2024,17(4):210-217.
[26]
中华医学会肿瘤学分会早诊早治学组. 中国结直肠癌早诊早治专家共识(2023版)[J/OL]. 中华普通外科学文献(电子版),2024,18(1):1-13.
[27]
Borstlap WA,Coeymans TJ,Tanis PJ,et al. Meta-analysis of oncological outcomes after local excision of pT1-2 rectal cancer requiring adjuvant (chemo)radiotherapy or completion surgery[J]. Br J Surg,2016,103(9):1105-1116.
[28]
You YN,Roses RE,Chang GJ,et al. Multimodality salvage of recurrent disease after local excision for rectal cancer[J]. Dis Colon Rectum,2012,55(12):1213-1219.
[29]
中华医学会外科学分会结直肠外科学组. 低位直肠癌经括约肌间切除术中国专家共识(2023版)[J]. 中华胃肠外科杂志,2023,26(6):536-547.Chinese Society of Colorectal Surgery. Chinese expert consensus on intersphincteric resection for low rectal cancer (2023 edition)[J]. Chin J Gastrointest Surg,2023,26(6):536-547.
[30]
Bernstein TE,Endreseth BH,Romundstad P,et al. What is a safe distal resection margin in rectal cancer patients treated by low anterior resection without preoperative radiotherapy?[J]. Colorectal Dis,2012,14(2):e48-55.
[31]
池畔,兰宝金,陈玲珑,等. 盆腔自主神经的解剖特点及其在直肠癌术中的临床应用[J]. 医学新知杂志,2004,14(1):31-32,37.Chi P,Lan BJ,Chen LL,et al. Anatomical characteristics of pelvic autonomic nerves and their clinical application in rectal cancer surgery[J]. Medical Recent Advances,2004,14(1):31-32,37.
[32]
池畔,王枭杰. 直肠侧方膜解剖完整对盆丛神经保护的意义[J]. 中华胃肠外科杂志,2021,24(4):297-300.Chi P,Wang XJ. The Significance of intact lateral rectal fascia anatomy in the protection of pelvic plexus nerves[J]. Chin J Gastrointest Surg,2021,24(4):297-300.
[33]
周声宁,韩方海. 腹腔镜下直肠癌根治术保留自主神经的解剖和技术要点 [J/CD]. 中华结直肠疾病电子杂志,2019,8(1):6-11.Zhou SN,Han FH. Anatomical and technical key points for preserving autonomic nerves during laparoscopic radical resection for rectal cancer[J/CD]. Chin J Colorec Dis(Electronic Edition),2019,8(1):6-11.
[34]
常远,白杨,王文秀,等. 腹腔镜改良Bacon手术中应用一针外置肠管固定法临床研究[J]. 中国实用外科杂志,2023,43(8):915-919.Chang Y,Bai Y,Wang WX,et al. Clinical study on the application of one-stitch external intestinal fixation in laparoscopic modified bacon surgery[J]. Chinese Journal of Practical Surgery,2023,43(8):915-919.
[35]
Bosset JF,Collette L,Calais G,et al. Chemotherapy with preoperative radiotherapy in rectal cancer[J]. N Engl J Med,2006,355(11):1114-1123.
[36]
Bahadoer RR,Dijkstra EA,Van Etten B,et al. Short-course radiotherapy followed by chemotherapy before total mesorectal excision (TME) versus preoperative chemoradiotherapy,TME,and optional adjuvant chemotherapy in locally advanced rectal cancer(RAPIDO):a randomised,open-label,phase 3 trial [J]. The Lancet Oncology,2021,22(1):29-42.
[37]
Jin J,Tang Y,Hu C,et al. Multicenter,randomized,phase III trial of short-term radiotherapy plus chemotherapy versus long-term chemoradiotherapy in locally advanced rectal cancer (STELLAR)[J]. J Clin Oncol,2022,40(15):1681-1692.
[38]
Zhu J,Liu A,Sun X,et al. Multicenter,randomized,phase III trial of neoadjuvant chemoradiation with capecitabine and irinotecan guided by UGT1A1 status in patients with locally advanced rectal cancer[J]. J Clin Oncol,2020,38(36):4231-4239.
[39]
Bascoul-Mollevi C,Gourgou S,Borg C,et al. Neoadjuvant chemotherapy with FOLFIRINOX and preoperative chemoradiotherapy for patients with locally advanced rectal cancer (UNICANCER PRODIGE 23):health-related quality of life longitudinal analysis[J].Euro J Cancer (Oxford,England:1990),2023,186:151-165.
[40]
Lin ZY,Zhang P,Chi P,et al. Neoadjuvant short-course radiotherapy followed by camrelizumab and chemotherapy in locally advanced rectal cancer (UNION):early outcomes of a multicenter randomized phase III trial [J]. Ann Oncol,2024,35(10):882-891.
[41]
Basch E,Dueck AC,Mitchell SA,et al. Patient-reported outcomes during and after treatment for locally advanced rectal cancer in the PROSPECT trial (Alliance N1048)[J]. J Clin Oncol,2023,41(21):3724-3734.
[42]
Glynne-Jones R,Wallace M,Livingstone JI,et al. Complete clinical response after preoperative chemoradiation in rectal cancer:is a “wait and see” policy justified?[J]. Dis Colon and rectum,2008,51(1):10-20.
[43]
Van Der Valk M JM,Hilling DE,Bastiaannet E,et al. Long-term outcomes of clinical complete responders after neoadjuvant treatment for rectal cancer in the International Watch & Wait Database (IWWD):an international multicentre registry study[J]. Lancet (London,England),2018,391(10139):2537-2545.
[44]
Lordan JT,Karanjia ND,Quiney N,et al. A 10-year study of outcome following hepatic resection for colorectal liver metastases - The effect of evaluation in a multidisciplinary team setting[J]. Eur J Surg Oncol,2009,35(3):302-306.
[45]
中国医师协会外科医师分会,中华医学会外科学分会胃肠外科学组,中华医学会外科学分会结直肠外科学组,等. 中国结直肠癌肝转移诊断和综合治疗指南(2023版)[J]. 中华消化外科杂志,2023,22(1):1-28.Chinese Society of Surgeons,Chinese Medical Association;Gastrointestinal Surgery Branch,Surgical Branch,Chinese Medical Association; Colorectal Surgery Branch,Surgical Branch,Chinese Medical Association,et al. Guidelines for diagnosis and multidisciplinary treatment of hepatic metastasis from colorectal cancer in China (2023 Edition) [J]. Chinese Journal of Digestive Surgery,2023,22(1):1-28.
[46]
姚宏伟,修典荣,付卫,等. 可切除结直肠癌伴肝转移的微创手术治疗模式探索:前瞻性研究[J]. 中华肝胆外科杂志,2012,18(11):841-845.Yao HW,Xiu DR,Fu W,et al. Exploration of minimally invasive surgical treatment modalities for resectable colorectal cancer with liver metastases:a prospective study[J]. Chinese Journal of Hepatobiliary Surgery,2012,18(11):841-845.
[47]
Boudjema K,Locher C,Sabbagh C,et al. Simultaneous versus delayed resection for initially resectable synchronous colorectal cancer liver metastases:a prospective,open-label,randomized,controlled trial[J].Ann Surg,2021,273(1):49-56.
[48]
Yin Z,Liu C,Chen Y,et al. Timing of hepatectomy in resectable synchronous colorectal liver metastases (SCRLM):simultaneous or delayed?[J]. Hepatology (Baltimore,Md),2013,57(6):2346-2357.
[49]
Nordlinger B,Sorbye H,Glimelius B,et al. Perioperative FOLFOX4 chemotherapy and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC 40983):long-term results of a randomised,controlled,phase 3 trial[J]. The Lancet Oncology,2013,14(12):1208-1215.
[50]
Kanemitsu Y,Shimizu Y,Mizusawa J,et al. Hepatectomy followed by mFOLFOX6 versus hepatectomy alone for liver-only metastatic colorectal cancer (JCOG0603):a phase II or III randomized controlled trial[J]. J Clin Oncol,2021,39(34):3789-3799.
[51]
Wang DS,Ren C,Li SS,et al. Cetuximab plus FOLFOXIRI versus cetuximab plus FOLFOX as conversion regimen in RAS/BRAF wildtype patients with initially unresectable colorectal liver metastases(TRICE trial):a randomized controlled trial[J]. PLoS Med,2024,21(5):e1004389.
[52]
Bond MJG,Bolhuis K,Loosveld OJL,et al. First-line systemic treatment strategies in patients with initially unresectable colorectal cancer liver metastases (CAIRO5):an open-label,multicentre,randomised,controlled,phase 3 study from the Dutch Colorectal Cancer Group[J]. The Lancet Oncology,2023,24(7):757-771.
[53]
Blomgren H,Lax I,Näslund I,et al. Stereotactic high dose fraction radiation therapy of extracranial tumors using an accelerator.Clinical experience of the first thirty-one patients[J]. Acta oncologica(Stockholm,Sweden),1995,34(6):861-870.
[54]
Puijk RS,Ruarus AH,Vroomen L,et al. Colorectal liver metastases:surgery versus thermal ablation (COLLISION) - a phase III singleblind prospective randomized controlled trial[J]. BMC cancer,2018,18(1):821.
[55]
Tinguely P,Laurell G,Enander A,et al. Ablation versus resection for resectable colorectal liver metastases - Health care related cost and survival analyses from a quasi-randomised study[J]. Euro J Surg,2023,49(2):416-425.
[1] 杜升兰, 张刘平, 肖燕玲. 三种手术策略在结直肠癌并肠梗阻中的临床观察[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(03): 294-297.
[2] 陈亮亮, 郭磊, 刘文思, 金从稳. 腹腔镜超低位直肠癌ISR手术难度的骨盆影像解剖学研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(03): 305-308.
[3] 赵敏, 韩加刚. 保留左结肠动脉的腹腔镜直肠癌根治术的临床效果观察[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(03): 313-316.
[4] 肖建, 肖天保, 陈江, 杨桃, 何峰, 保甜甜, 曹一波, 杨琴, 赵颖. 吲哚菁绿成像技术在保留左结肠动脉的直肠癌根治术中的应用价值[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(02): 134-137.
[5] 左从奎, 毕迎春, 姚琼. 不同IMV 结扎水平的直肠癌全直肠系膜切除术临床效果对比研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(02): 138-141.
[6] 金芳, 徐东飞, 尚培中, 张伟, 葛艳丽, 李晓英, 苗建军, 郭伟林. 腹腔镜直肠癌Dixon手术选择性应用超声刀和电钩的效果评价[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(02): 142-145.
[7] 周丽君, 王露, 林巧. 腹腔镜与开腹直肠癌切除术治疗中低位直肠癌的疗效及并发症对比[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(02): 146-148.
[8] 卢晓云, 黄勇, 王继伟, 李建国, 谢铭. 直肠癌预防性造口还纳时机研究进展[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(02): 216-219.
[9] 赵丽霞, 王春霞, 陈一锋, 胡东平, 张维胜, 王涛, 张洪来. 内脏型肥胖对腹腔镜直肠癌根治术后早期并发症的影响[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 35-39.
[10] 吴晖, 佴永军, 施雪松, 魏晓为. 两种解剖入路下行直肠癌侧方淋巴结清扫的效果比较[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 40-43.
[11] 周世振, 朱兴亚, 袁庆港, 刘理想, 王凯, 缪骥, 丁超, 汪灏, 管文贤. 吲哚菁绿荧光成像技术在腹腔镜直肠癌侧方淋巴结清扫中的应用效果分析[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 44-47.
[12] 徐逸男. 不同术式治疗梗阻性左半结直肠癌的疗效观察[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 72-75.
[13] 李代勤, 刘佩杰. 动态增强磁共振评估中晚期低位直肠癌同步放化疗后疗效及预后的价值[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 100-103.
[14] 姚焕章, 宋华传, 王永帅, 张珅瑜, 王继洲. 同期手术治疗同时性结直肠癌肝转移的安全性与疗效[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(02): 238-244.
[15] 中国抗癌协会, 中国抗癌协会大肠癌专业委员会. 中国恶性肿瘤整合诊治指南-直肠癌(2024 版)[J/OL]. 中华结直肠疾病电子杂志, 2025, 14(01): 1-19.
阅读次数
全文


摘要