中低位直肠癌行全直肠系膜切除临床分析

The clinical analysis of total mesorectal excision(TME) in the treatment of middle and lower rectal carcinoma

目的:探讨中低位直肠癌行全直肠系膜切除的方法与疗效。方法:回顾我院于1998年7月￣2005年8月间75例中低位直肠癌行全直肠系膜切除术(TME)病例,并与1990年1月￣1998年6月间83例中低位直肠癌传统手术方式进行比较。结果:TME组保肛率56%(42/75),2年内局部复发率7.55%(4/53),3年生存率78.57%(33/42),5年生存率66.67%(14/21);传统手术组保肛率34.94%(29/83),2年内局部复发率25.30%(21/83),3年生存率59.04%(49/83),5年生存率40.96%(34/83)。两组比较采用卡方检验P<0.05,差异有显著性。结论:中低位直肠癌行全直肠系膜切除可降低局部复发率,提高生存率及保肛率。

Objective To analyze the method and efficacy of total mesorectal excision（TME） in the treatment of middle and lower rectal carcinoma. Method The clinical data of 75 cases with middle and lower rectal carcinoma who underwent TME between July 1998 and August 2002 were analyzed retrospectively. The data was compared with that of another 83 cases who underwent traditional operation between January 1990 and June 1998. Results In the TME group, sphincter conservative rate was 56%（42/ 75）, local recurrent rate in two years was 7,55%（4/53）, the 3-year survival rate was 78.57%（33/42）, the S-year survival rate was 66.67% （ 14/21 ）, while in the traditional group, were 34.94% （29/83）, 25.30% （21/83）, 59.04% （49/83）,40.96% （34/83） respectively. The difference between the two groups was significant（P〈 0.05）. Conclusion The TME in the treatment of middle and lower rectal carcinoma can decrease the local recurrent rate and increase the survival rate and sphincter conservative rate.