保肛手术在高龄低位直肠癌患者中的应用

Anus-protective operation for the aged patients with low rectal carcinoma

目的探讨保肛术式在高龄低位直肠癌患者中应用的可行性。方法总结47例距肛缘7cm内高龄低位直肠癌患者的临床资料,其中距肛缘3～5cm11例,5.1～7cm36例;DukesA期10例,B期32例,C期5例;行Dixon术38例,Parks术5例,Bacon术4例。并与同期68例直肠癌行Miles术高龄患者比较术后局部复发率、存活率。结果保肛术局部复发率为17.1%,3年和5年存活率分别为65.9%和59.6%;而Miles术则分别为16.2%、67.6%,51.5%,二者差异均无显著性(P>0.05)。结论高龄低位直肠癌保肛术掌握好适应症后,可获得长期存活率,并提高生活质量。

Objective To explore the feasibility of anus -protective operations for the aged patients with low rectal carcinoma. Methods The clinical data of 47 cases with low rectal carcinoma whose affected rectum was 7 cm from the edge of anus were collected. Among them 11 cases lowest affected part was 3～5 cm from the edge of anus and 36 cases 5～7 cm from anus. And 10 cases were in Dukes stage A, 32 cases were in Dukes stage B and 5 cases were in Dukes stage C, 38 cases were treated with Dixon operation, 5 with Parks operation and 4 with Bacon operation. The local recurrence rate and survival rate of the above operations were compared with those of the Miles operations on 68 patients with rectal carcinoma. Results The local recurrence rate of anus-protective operation and 3-year, 5-year survival rates were 17.1%, 65.9% and 59.6% respectively, while those of Miles operations were 16. 2%、67.6% and 51.5% respectively( P>0.05). Conclusion Anus-protective operation provides effective treatment for low rectal carcinoma with a satisfactory long term survival rate and quality of life.