目的:比较低位直肠癌几种术式的复发率及5年生存率的差异,探讨术式的选择。方法:收集我院2001~2008年收治268例低位直肠癌病例资料,按局部切除,TME+DIXON、TME+MILES分成三组,对术后复发率及5年生存率进行回顾分析。结果:局部切除组12例,2年局部复发2例,复发率16.%,TME+DIXON组192例,总保肛率84.%,2年复发45例,复发率16.%,5年生存率61.%,TME+MILES术64例,2年复发11例,复发率17%,5年生存率59%,三组病例2年复发率相近,统计学数据显示无显著性差异(P gt;0.5)。结论:对低位直肠癌,可根据病灶大小,病理学类型,Dukes分期等把握术式选择的适应症:保肛术式为首选, Miles术为最后的选择。
Citation:
HE Ao,WU Jianping,LUO Wenjun.. Operative Procedure and Effective for Patients with Low Rectal Cancer. West China Medical Journal, 2009, 24(7): 1644-1646. doi:
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ENKER WE,THALER HT,CRANER ML, et al.Total mesorectal excisinn in the operative treadment of carcinoma of the rectem[J].J Am Coll Surg, 1995,181:335-46.
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UWIDLIAMS NS, DIXON MF, JOHNSTON D. Eappraisal of the centimetre rule of distal excision for carcinoma of the rectum:a study of distal intramuralspread and of patients survival[J].BrJ Surg,1983,70:150-54.
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SAGAR PM,PEMBERTON JH.Surgical management of locally recurrent rectal cancer[J].Br J Surg,1996,83(3):293-04.
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邵水孚.重视直肠癌术后局部复发的预防[J].中国胃肠外科杂志,2000,3(4):201-02.
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5. |
ENKER WE.Total mesorectal excisionthe new golden standard of surgery for rectal cancer[J].Ann Med,1997,29(2):127-33.
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SAITO N, ONO M, SUGITO M, et al. Early besults of intersphincteric resection for patients with very low rectal cancer:an active approach to avoid a perminant colostomy[J].Dis Colon Rectum,2004,47(4):459-66.
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- 1. ENKER WE,THALER HT,CRANER ML, et al.Total mesorectal excisinn in the operative treadment of carcinoma of the rectem[J].J Am Coll Surg, 1995,181:335-46.
- 2. UWIDLIAMS NS, DIXON MF, JOHNSTON D. Eappraisal of the centimetre rule of distal excision for carcinoma of the rectum:a study of distal intramuralspread and of patients survival[J].BrJ Surg,1983,70:150-54.
- 3. SAGAR PM,PEMBERTON JH.Surgical management of locally recurrent rectal cancer[J].Br J Surg,1996,83(3):293-04.
- 4. 邵水孚.重视直肠癌术后局部复发的预防[J].中国胃肠外科杂志,2000,3(4):201-02.
- 5. ENKER WE.Total mesorectal excisionthe new golden standard of surgery for rectal cancer[J].Ann Med,1997,29(2):127-33.
- 6. SAITO N, ONO M, SUGITO M, et al. Early besults of intersphincteric resection for patients with very low rectal cancer:an active approach to avoid a perminant colostomy[J].Dis Colon Rectum,2004,47(4):459-66.