摘要
目的观察经肛门局部切除术和经腹根治性切除术治疗中低位T1期直肠癌的效果及预后生存情况。方法选取2009年1月—2012年6月收治的96例中低位T1期直肠癌。按照手术方法分为局部组51例和根治组45例,其中局部组行经肛门局部切除术治疗,根治组行经腹根治性切除术治疗。观察2组术中及术后相关指标、术后并发症发生率以及随访情况。结果局部组术中出血量、手术时间、肿瘤距肛缘距离、胃肠道功能恢复时间、住院时间及首次下床活动时间均明显低于根治组(P<0.01)。根治组肺部感染发生率高于局部组(P<0.05)。局部组肛门失禁与性功能障碍的发生率明显低于根治组(P<0.05)。2组5年总生存率和无瘤生存率比较差异无统计学意义(P>0.05)。结论经肛门局部切除术治疗中低位T1期直肠癌的临床疗效肯定,在降低术中出血量、促进胃肠道功能恢复、保护肛门功能和性功能方面明显优于经腹根治性切除术。
Objective To investigate curative effect and survival condition of transanal local excision and transabdominal radical resection in treatment of patients with stage T1 middle and low rectal cancer. Methods A total of 96 patients with stage T1 middle and low rectal cancer admitted during Janual7 2009 and June 2012 were divided into local group （n = 51 ） and radical group （n = 45 ） according to different operative methods. Local group was treated with transanal local excision, while radical group was treated with transabdominal radical resection. Intraoperative and postop- erative indexes, postoperative incidence rate of complications and follow-up conditions were observed in two groups. Results Values of bleeding volume, operative time, distance from tumor to anal margin, recovery time of gastrointestinal tract function, hospitalization time and the first time of out-of-bed activity were significantly lower than those in radical group （ P 〈 0.01 ）. Incidence rate of pulmonary infection in radical group was significantly higher than that in local group （ P 〈 0.05 ）. Incidence rates of anal incontinence and sexual dysfunction were significantly lower in local group than those in radical group （ P 〈 0. 05 ）. There were no significant differences in 5 years overall survival rate and the tumor free survival rate between two groups （ P 〉 0. 05 ）. Conclusion Transanal local excision in treatment of patients with stage T1 middle and low rectal cancer may achieve good curative effect, and it is superior to transabdominal radical resection in reducing intraoperative blood loss, promoting recovery of gastrointestinal function, protecting anal function and sexual function.
作者
邓建勇
甄彦龙
马林
DENG Jian-yong;ZHEN Yan-long;MA Lin(Department of Anorectal Surgery;Department of General Surgery,Baoji Hospital of Traditional Chinese Medicine,Baoji,Shaanxi 721001,China)
出处
《解放军医药杂志》
CAS
2018年第7期35-38,共4页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
陕西省科技计划发展项目(2011K15-06-09)
关键词
直肠肿瘤
经肛门局部切除术
经腹根治性切除术
治疗效果
预后
Rectal neoplasms
Transanal local excision
Transabdominal radical resection
Treatment effectiveness
Prognosis
