中低位直肠癌保肛手术治疗的临床疗效观察  

Observation of clinical efficacy of anus-preserving operation in treatment of middle or lower rectal cancer

作　　者：艾晓辉 黎孝坚 张华林 王海 何海波 莫军[2] 陈鹏 邹伯勋[4] 

机构地区：[1]湖南省邵阳市肿瘤医院普外科,422000 [2]湖南省邵阳市第一人民医院普外科 [3]湖南省邵阳市中心医院普外科 [4]湖南省肿瘤医院普外科,410006

出　　处：《中国肿瘤临床与康复》2007年第4期329-331,共3页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨中低位直肠癌保肛手术治疗的远期疗效及保肛手术治疗中低位直肠癌的原则。方法回顾性分析1997年3月至2003年9月收治455例中低位直肠癌的手术方式和随访资料。结果中低位直肠癌的手术方式中,保肛组与联合组患者在年龄、性别、肿瘤大小、组织学类型、分化程度、Dukes分期、手术时间、术后并发症、局部复发率、生存率上比较差异均无显著性。保肛组肿瘤切除后肛提肌上直肠残端的平均长度为(4.03±2.46)cm,联合组为(2.38±1.75)cm(P<0.01)。结论在根治性切除的前提下,保肛组生存率并不比联合组低,局部复发率并不比联合组高,且生活质量明显提高。适当扩大盆腔内切除范围是减少低位直肠癌术后局部复发的关键。保肛手术治疗中低位直肠癌并不影响远期疗效。Objective To investigate the long-term therapeutic effects of the anus-preserving operation on middle or lower rectal cancer. Method Clinical and follow-up data of 455 patients with middle or lower rectal cancer treated surgically from March 1997 to September 2003 were retrospectively analyzed. Resuits No significant difference was found in age, gender, tumor size, histological type, differentiation, Dukes stage, time of operation, postoperative complications, local recurrence and survival rate between the patients receiving anus-preserving operation and those undergoing abdominoperineal resection . The average distance between levator ani and the end of remnant rectum after the cancer had been excised was 4.03 ± 2.46 and 2.38±1.75 cm in anus-preserving operation group and abdominoperineal resection group, respectively（ P 〈 0.01 ）. Conclusions After radical resection, the survival rate was not lower in anus-preserving operation group than in abdominoperineal resection group. The extension of incision in pelvic cavity is the key to prevent local recurrence in anus-preserving operation of middle or lower rectal cancer. The anus-preserving oper- ation is a good surgical procedure for the treatment of middle or lower rectal cancer.

关 键 词：直肠肿瘤/外科学 保肛手术 腹会阴联合根治术 

分 类 号：R735.37[医药卫生—肿瘤] R730.56[医药卫生—临床医学]