摘要
目的探讨直肠癌Miles手术后局部复发的原因及防治。方法1986年1月至2001年12月共行直肠癌Miles手术168例,对其中发生术后局部复发者27例进行回顾性临床分析。结果27例中有男性20例,平均年龄比首次手术组低5岁,19例属DukesC期,15例呈组织学高度恶性,17例肿瘤距肛门3～6cm。复发后再手术11例,5年生存率为27.2%(3/11),中位生存期25.4个月(5～144个月);单纯放化疗16例,中位生存期11.7个月(3～29个月),未手术者均在2年内死亡。结论术后局部复发与年龄、性别、病期、病理类型、肿瘤部位及根治是否彻底相关。预防复发之要点为做好首次手术。对复发病例宜力争早发现,并予再次手术为主的综合治疗,以延长其生存期。
Objective To discuss the causes of local recurrence and its prevention and treatment after Miles operation for rectal cancer. Methods From Jan 1986 to Dec 2001, 27 cases had local recurrence out of 168 cases after resection for rectal cancer. Results Among the cases of recurrence, 20 were male, their average age was 48 years as compared to 53 years of cases undergoing the first operation. Ninety cases belonged to Dukes'C, 15 cases presented highter degree of malignancy in pathological grading, 17 patients had tumors 3 to 6 cm above the anal margin. In the cases of recurrence, 11 were re-operated, and the 5-year survival rate was 27.2%(3/11); and in the other 16 cases who were not re-operated, all died within 2 years. Conclusions Local recurrence after Miles operation is closely related with factors as age, gender, late staging, high malignance in pathological grading, and site of tumor close to the anal margin. Radical resection should be carried out during the first operation. In those with recurrence, early diagnosis should be made and proper re-operation be proposed.
出处
《外科理论与实践》
2004年第4期304-306,共3页
Journal of Surgery Concepts & Practice
关键词
直肠癌
MILES术
局部
复发
Rectal Cancer
Miles' operation
Location
Recurrence
