高龄低位直肠癌经骶尾部局部切除加放疗的疗效观察

Observation of the Curative Effect using Transsacral Local Excision and Radiotherapy in the Eldly Patients with low Rectal Cancer

目的:探讨经骶尾部局部切除加术后放疗在高龄低位直肠癌保肛治疗中的作用。方法:将24例年龄≥70岁,肿瘤距肛缘≤7cm,经病理证实为直肠癌而拒绝行Miles术式的患者采用经骶尾部直肠癌局部切除加术后放疗,观察其疗效。结果:本组病例无手术死亡者;术后切口感染1例,经换药治愈;缝合口瘘2例,经保守治愈。全部病例术后均有良好肛门功能,康复出院。19例获随访,随访3年,2例局部复发,拒绝再次手术,予以放疗。1年生存率为84.2%,3年生存率达52.6%。结论:对高龄低位直肠癌而拒绝行Miles术式者,经骶尾部局部切除加放疗疗效确切,安全性高,是一种不错的选择。

Objective： To observe the curative effect by using transsacral local excision and radiotherapy in the eldly patients with low rectal cancer. Method： 24 cases of eldly patients with low rectal cancer who refused the miles operation have been used transsacral local excision and radiotherapy. Result： There were not dead cases in the treatment and the operation had a good effect of reserving anus. 1 case incision was infected and recovered soon. 2 cases with anastomose fistula were recovered through conservative therapy. 19 cases were investigated for three years. One - year survival rate was 84.2%. Three - year survival rate was 52.6%. Conclusion： Transsacral local excision and radiotherapy in the eldly patients who refused the miles operation with low rectal cancer is a safety and expectant effect operation.