直肠癌术后复发的诊断和治疗  

Local recurrence of rectal carcinoma： diagnosis and treatment

作　　者：高显华[1] 张卫[1] 

机构地区：[1]第二军医大学附属长海医院肛肠外科,上海200433

出　　处：《国际外科学杂志》2009年第11期789-792,共4页International Journal of Surgery

基　　金：上海市科委自然科学基金（No.08ZR1404600）;上海市科委自然科学基金（No.07dz9505）

摘　　要：直肠癌是我国常见的恶性肿瘤。全直肠系膜切除术（TME）和术前放疗的应用使局部复发率大大下降，但是局部复发率仍然高达11．3％。手术仍然是局部复发性直肠癌最有效的治疗手段。如果能根治性切除，患者的5年生存率将可以达到30％以上。但是由于扩大根治术风险大，并发症多，只有一部分患者能从中获益。通过各种术前检查，准确把握扩大根治术的适应证非常重要。对于不能切除的晚期复发性直肠癌，通过积极的综合治疗也可以改善症状、提高生活质量、延长生存期。本文就直肠癌术后复发的诊断和治疗作一综述。Rectal carcinoma is a common malignant tumor in China. Although it decreased greatly after the introduction of total mesorectal excision and preoperative radiotherapy, the local recurrence rate of rectal carcinoma after curative surgery is still up to 11.3%. Surgery is the most effective treatment for local recurrence of rectal carcinoma. If excised radically, the five-year survival of patients with rectal carcinoma could be more than 35%. Only a few patients will benefit from extended radical surgery because of its extremely high postoperative morbidity and mortality. Strict selection of patients by multiple preoperative examinations makes extended radical surgery more reasonable. For the unresectable advanced recurrent rectal carcinoma, muhimodality palliative therapy could lead to symptom relief, elevated quality of life and prolonged survival. We discuss the diagnosis and treatment of recurrent rectal carcinoma in this review.

关 键 词：直肠肿瘤 预后 

分 类 号：R735.37[医药卫生—肿瘤] R737.9[医药卫生—临床医学]