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低位直肠癌147例外科治疗 被引量:2

Surgical treatment for 147 cases of low rectum cancer
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摘要 目的 为使低位直肠癌手术切除范围更合理 ,降低术后局部复发率 ,减少因人工肛门所造成的痛苦。方法 对 14 7例低位直肠癌外科手术进行回顾性分析。行各种方式的保肛手术 79例 ,行Mile′s手术 68例。Duke′s分期 :A期 17例 ,B期 72例 ,C期 5 8例。结果 本组无瘤生存 3年以上 93例占 72 .1% ;五年以上 71例占 63 .4%。术后局部复发 42例占 2 8.9%。其中盆腔内复发 2 7例占 64 .3 % ( 2 7/42 ) ,坐骨直肠窝内复发 5例占 11.9% ( 5 /42 ) ,吻合口复发 4例占 9.5 % ( 4 /42 )。局部复发与肿瘤病理类型及Duke′s分期有关 ,而与手术方式无关。结论 对低位直肠癌肿瘤分化程度高 ,Duke′s分期为B期、C期患者应适当扩大手术切除范围。对于肿瘤下缘距齿状线 3~ ? Objective To explore the rational extent resected in operation for low level rectum cancer to decrease the recurrence rate.Methods Of 147 cases of low rectum cancer including 99 cases were reserved anus and 68 cases underwent Mile′s operation. Results The 3 year survival rate was 72.1%(93 cases)and the 5 year survival rate was 63.4%(71 cases).The recurrence rate was 28.9%(42 cases),which was related to the pathological types and Duke′s stage, not to the operation method.Conclusions The low rectum cancer of Duke′s B or Duke′s C,which presents high malignance, should undergo extended radical operation.Those the distance of lower edge to the dentate line is more than 3~4cm should reserve anus as much as possible and the extended radical operation is key to reducing its recurrence rate. 〔
出处 《中国肿瘤临床与康复》 2000年第3期41-42,共2页 Chinese Journal of Clinical Oncology and Rehabilitation
关键词 低位直肠癌 外科治疗 low level rectum neoplasms surgical treatment
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  • 1周锡庚,沈耀祥,徐宝瑞.735例直肠癌的外科治疗和远期疗效[J]上海医学,1978(11).
  • 2Xi-Geng Zhou M.D., L.R.C.S. (Ed.),Bao-Ming Yu M.D.,Yao-Xiang Shen M.D.. Surgical treatment and late results in 1226 cases of colorectal cancer[J] 1983,Diseases of the Colon & Rectum(4):250~256

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