直肠癌外科治疗及远期疗效的评估  

Evaluation of surgical treatment and long term results in rectal carcinoma

作　　者：郁宝铭[1] 李东华[1] 沈耀祥[1] 郑民华[1] 王灏[1] 

机构地区：[1]上海第二医科大学附属瑞金医院外科,200025

出　　处：《临床外科杂志》1997年第2期64-66,共3页Journal of Clinical Surgery

摘　　要：本文总结1980年1月～1995年12月手术治疗直肠癌1106例的经验，并比较80年代和90年代两组病例的结果，以阐明低位直肠癌时选作保肛手术的原则。1990年起采用双吻合器，其手术并发症及术后复发均少于80年代。90年代保肛手术与Miles手术的手术死亡率均低于80年代，而5年生存率均高于80年代。认为加强手术前后的辅助治疗，并严格按照肿瘤远端切除3cm正常肠段和术中直肠充分游离后，视肛直肠环是否切除，再决定手术原则，不但可使较多的低位直肠癌获得保留肛门括约肌功能的机会，并可获较好的远期疗效。The purpose of this paper is to summarize our experiences in surgical treatment in 1106 cases of the rectal carcinoma during the period between january 1980 and December 1995 and to compare the results of those treated in 80s' with those in 90s' The curative resectability rate in 90s' (90. 43% ) was also higher than in 80s' (86.2 % ). The overali operative mortality rate was 0.63%, 0. 84% in 80s' and 0. 39 % in 90s'. SSR can be safely carried out in low rectal carcinoma with supplement of adjuvant therapy if one select the patient strictly according to the rules of the distal resection is no less than 3 cm and decision of the operative procedure is just made after adequate mobilization of the rectum. So not only more patients with low rectal carcinoma have the feasibility of the sphincter preservation but also have a better long term results.

关 键 词：直肠肿瘤 癌 外科手术 

分 类 号：R735.370.5[医药卫生—肿瘤]