直肠癌全直肠系膜切除术的临床分析  

Clinical Analysis of Radical Resection with Total Mesentery Excision(TME) for the Treatment of Rectal Cancer

作　　者：赵宏[1] 王海涛[1] 陈少骥[1] 高敏[1] 张志德[1] 

机构地区：[1]苏州大学附属第一医院普外科,215006

出　　处：《大肠肛门病外科杂志》2005年第2期106-108,共3页Journal of Coloproctological Surgery

摘　　要：目的:探讨直肠癌全直肠系膜切除术(TME)的应用效果。方法:统计89例TME手术和97例传统手术清除淋巴结情况,观察两组病人术后吻合口漏发生率及术后3年局部复发率。结果:在有淋巴结转移的病人中,TME手术平均清除转移淋巴结(3.8±1.5)个,而传统手术为(3.1±1.6)个,两者具有统计学差异(P<0.05)。术后吻合口漏发生率:TME为5.6%(5/89),传统手术为7.2%(7/97),无统计学差异(P>0.05)。术后3年局部复发率:TME为6.5%(3/46),传统手术为10.9%(6/55),有统计学差异(P<0.05)。结论:TME手术能提高直肠癌转移淋巴结的清除效果,降低术后局部复发率,值得推广。Objective： To evaluate the clinical effect of radical resection with TME for the treatment of rectal carcinoma. Methods： Data of 89 patients treated with TME operation and 97 patients with conventional radical operation were analysed. Results： 3. 8 ± 1. 5 metastatic lymph nodes were cleared in TME operation, whereas 3. 1 ± 1.6 metastatic lymph nodes were cleared in conventioal radical operation. The 3-year local recurrence rate was 6. 5%（3/46） in TME operation and 10. 9%（6/55） in conventional operation. The difference was significant in cleared metastatic lymph nodes and local recurrence rate between the two groups. Anastomotic leakage occurred in 5 patients （5. 6%） following TME and 7 patients （7. 2%） following conventional operation. There was no significant difference in anastomotic leakage between the two groups. Conclusion：TME operation can clear more metastatic lymph nodes of rectal carcinoma than conventional radical operation and there is a lower local recurrence rate after TME operation.

关 键 词：结直肠肿瘤 全系膜切除 肿瘤复发 淋巴结转移 外科手术 

分 类 号：R735.37[医药卫生—肿瘤]