再手术治疗局部复发性直肠癌78例临床分析

Value of reoperation in treatment of 78 cases of locally recurrent recta l cancer.

目的 探讨局部复发性直肠癌再手术的适应证及影响再手术的因素。方法 上海第二医科大学附属瑞金医院外科 1993年 10月至 2003年 10月收治的 78例复发性直肠癌再手术前均行放疗,对其疗效进行回顾性分析。结果 78例中,根治性切除 32例,姑息性切除 46例,根治切除率为 41 .03%。手术死亡 2例,手术死亡率为 2 .56%。根治性手术组和姑息性手术组中位生存期分别为 35 .8个月和 12. 4个月。结论 再手术结合术前放疗是局部复发性直肠癌的首选治疗方法。

Objective To evaluate the indications of reoperation and pr ed ictors of radical resection in patients with locally recurrent rectal cancer. Methods Seventy-eight patients with locally recurrent rectal canc er at Ruijin Hospital of Shanghai Second Medical University from 1993 to 2003 un derwent preoperative radiotherapy follwoed by reoperation.The therapeutic result s of all patients were reviewed.Results Among 78 cases,32 cases were treated with radical resec tion,46 cases with palliative resection.Operative mortality was 2.56%.For radic al resection group and palliative operation group,the median survival time were 35.8 months and 12.4 months,respectively.Conclusion Reoperati on combined with preoperative radiotherapy is the first choice for treatment of locally recurrent rectal cancer.