影响直肠癌根治术后局部复发的因素(附37例临床分析)

Affective Factors of Local Relapse of Radical Operation of Rectal Carcinoma after Operation

目的根据现有临床资料，分析、了解直肠癌术后局部复发的相关因素，及再次手术治疗的生存率、预后相关因素等情况。方法回顾性分析1998—06，2004—07我院收治37例直肠癌术后局部复发病例资料。结果37例中，会阴部复发8例，吻合口处复发12例，盆腔、腹腔种植复发17例。本组病例均再次手术治疗，其中根治性切除率54％（20／37），姑息性切除率46％（17／37）。结论早期诊断、合理治疗，切除足够肠管、彻底切除淋巴结及所在肠系膜和术中无瘤操作，是减少直肠癌根治术后复发的主要措施。对复发病例应该根据复发部位、病期早晚采取以手术为主的综合治疗方案。局部复发的直肠癌能否根治性切除是影响其预后的独立因素，能再次行根治性手术的局部复发直肠癌预后好。我们主张对直肠癌根治术后局部复发的患者，如条件允许应积极手术治疗。

Objective To analyze the relative factors of local relapse, survival rate of re - operation and prognosis after rectal carcinoma operation. Methods The clinical materials of 37 cases of such patient from June 1998 to July 2004 were analyzed retrospectively. Results There were 8 cases of relapse at perineal region, 12 cases at anastomosis and 17 eases at plantation of abdomen and pelvic cavity. The re - operation was performed in this group among them the radical operation was 54% palliation operation was 46%. Condusion The early diagnosis, reasonable treatment and thoroughly performance to remove enough intestine, lymph node and mesentery might be the key point to prevent local re lapse. The complex treatment should be based on the location and stage of relapse that mainly operation should be taken if the situation of patient is available.