全盆腔脏器切除术治疗直肠癌术后盆腔局部复发  

Total pelvic exenteration for locally postoperative recurrent rectal cancer

作　　者：潘义生[1] 万远廉[1] 刘玉村[1] 汪欣[1] 吴涛[1] 黄珊君[1] 

机构地区：[1]北京大学第一医院普外科,100034

出　　处：《中华普通外科杂志》2005年第6期329-331,共3页Chinese Journal of General Surgery

摘　　要：目的评价全盆腔脏器切除术(totalpelvicexenteration,TPE)治疗盆腔局部复发直肠癌(locallyrecurrentrectalcancer,LRRC)的疗效。方法对1989—2003年行TPE治疗的35例直肠癌患者的临床资料进行分析。结果行TPE30例、保肛TPE2例、TPE联合骶、尾骨切除2例、TPE联合半骨盆切除1例。根治性切除率80%,手术死亡率3%,术后盆腔再复发率48%。全组术后5年生存率16%,根治性切除组为19%,无淋巴结转移者5年生存率24%,有淋巴结转移者为0。结论TPE手术成功的关键在于严格的适应证选择和作到真正的根治性切除。Objective To evaluate total pelvic exenteration (TPE) in the treatment of locally recurrent rectal cancer (LRRC). Methods Clinical data of 35 patients with LRRC who underwent TPE between 1989 and 2003 were analyzed retrospectively. Results Thirty patients underwent TPE, the remaining 2 did sphincter-preserving TPE, 2 with lower sacrectomy and 1 with hemipelvectomy, among them 80% cases received radical resection. Operative mortality rate was 3%, and morbidity rate was 51%. The overall post TPE tumor local recurrence rate was 48%. The 5-year survival rate was 16% in all cases and 19% in radical resection group. The 5-year survival rate in patients without lymph node metastasis was 24%, and 0 in patients with metastasis. Conclusion Effective TPE treatment lies in strict patient selection and radical resection.

关 键 词：全盆腔脏器切除术 直肠癌 盆腔 局部复发 肿瘤 消化系统 盆腔廓清术 

分 类 号：R735.37[医药卫生—肿瘤]