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16例直肠癌局部复发的再手术治疗结果分析

An analysis for 16 cases of surgery for locally recurrent rectal cancer
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摘要 目的分析和总结16例直肠癌术后局部复发再手术的临床资料。方法该院1998年1月~2004年6月收治直肠癌局部复发后再次手术治疗16例,对患者的第1次手术情况、再次手术探查结果、再手术方法的选择、术后并发症及其预后等资料进行了回顾性分析。结果16例接受再手术的患者中,首次手术与复发后再次手术的平均间隔时间为(28.4±3.6)个月,其中12例完成了根治性肿瘤再次切除,4例施行姑息性手术治疗。5例患者(31.3%)出现了各类术后并发症共计9项,其中泌尿系统的损伤共4例,无住院死亡病例。随访16例患者中死亡9例(43.8%),平均生存期为(27.6±3.2)个月。4例接受姑息性再手术的患者术后生存期为(10.2±4.1)个月,12例接受根治性再手术的病例术后生存期为(30.3±3.8)个月,显著高于复发后接受姑息性手术的患者。结论经过严格的术前检查和选择的直肠癌局部复发病例,进行积极的再手术治疗是一种安全和有效的手段。 [Objective] To retrospectively analyze the outcome of 16 cases of patients who underwent resection of locally recurrent rectal cancer. [Methods] We reviewed the medical and follow-up records of 16 patients who underwent surgery with a curative intent for locally recurrent rectal cancer between January 1998 and June 2004. Details were assessed on the primary tumor, abdominal exploration findings, surgery method, complications, and prognosis. [Results] The time interval between the primary tumor resection and the surgery for locally recurrent disease was (28.4±3.6) months. A radical resection for locally recurrent tumor was performed in 12 cases, while the other four patients received a palliative surgery. A total of nine complications happened to five patients; including the most common injuries of urinary system in four patients (25.0%). However, no patient died during postoperative hospital stay. Up to October 2006, the mean survival time was (27.6±3.2) months with nine cases of death (43.8%). The mean survival time of the subjects received radical reoperation (30.3±3.8) months was significantly than that of the patients underwent palliative surgery (10.2±4.1) months. [Conclusion] With careful preoperative selection and sufficient surgical skills, surgery for locally recurrent rectal cancer can be performed on a proportion of patients safely and effectively.
出处 《中国医学工程》 2006年第6期638-640,共3页 China Medical Engineering
关键词 直肠癌 局部复发 再手术 recurrent rectal cancer, multimodal treatment surgery
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参考文献12

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