经肛门局部切除术与根治术治疗早期直肠癌远期疗效比较  

Clinical comparative analysis of transanal local excision and radical resection in treatment of early rectal cancer

作　　者：钟华戈[1] 赵波[2] 徐艳松[3] 

机构地区：[1]钦州市第二人民医院普通外科,广西钦州535000 [2]广西医科大学第一附属医院微创外科,广西南宁530021 [3]广西医科大学第一附属医院急诊外科,广西南宁530021

出　　处：《结直肠肛门外科》2014年第6期389-394,共6页Journal of Colorectal & Anal Surgery

摘　　要：目的比较经肛门局部切除及根治术治疗早期直肠癌的远期疗效。方法通过PubMed、CNKI数据库及文献追踪法检索直肠癌经肛门局部切除及根治术治疗早期(T1期和T2期)直肠癌远期疗效比较的文献,应用RevMan 5.0软件对各研究结果进行异质性检验和效应值合并。结果共筛选出符合入选标准的临床研究15项,局部切除术3504例,根治术6925例。早期直肠癌局部切除和根治术比较,局部切除术会增加T1、T2期术后5年局部复发率;局部切除术明显降低T1、T2期术后5年总生存率;局部切除术降低T1期术后5年无病生存率,而并不能改善T2期术后5年无病生存率。结论与直肠癌根治术相比,早期直肠癌经肛门局部切除术的远期疗效差,临床上要慎重考虑局部切除术的利弊。Objective To compare the application of transanal local excision and radical resection on the long-term effect of early rectal cancer.Methods A comprehensive literature search for relevant studies published up to December 2013 was performed using PubMed,and China National Knowledge Infrastructure.The comparison of long-term curative effect between local excision and radical resection for early rectal cancer（T1and T2）in literature was analyzed.The RevMan 5software was used to test for heterogeneity and the effect on the results of value combination.Results We screened 15 eligible clinical researches,local excision in 3504 cases,6925cases of radical resection.The local excison will increase 5-year local recurrence rate on T1,T2 phase,and the ocal excision obveriously decreased 5-year overall survival rate on early rectal cancer.The local excision districtly decreased 5-year disease free survival rate on T1 phase,and do not improve 5-year disease free survival rate on T2 phase.Conclusion Compared with radical resection,the long term effect of local excision is poor,so we must carefully consider the pros and cons of local excision on clinic.

关 键 词：早期直肠癌 局部切除术 根治术 

分 类 号：R735.37[医药卫生—肿瘤]