直肠癌前切除术后局部复发42例分析

Analysis of Local Relapse after Anterior Resection of Rectal Carcinoma in 42 Cases

为探讨直肠癌前切除术后局部复发的原因、诊断及再手术方法，回顾分析42例直肠癌前切除术后局部复发病例，吻合口复发7例，吻合口上方盆腔复发9例，吻合口下方骶前复发14例，吻合口下方盆腔侧壁及前方复发12例。2年内局部复发率为88．1％，再次手术肿瘤切除率为35．7％。结果表明，直肠癌局部复发常在术后2年内。密切随访直肠指诊有助于早期诊断，对局部复发病例应采取积极的手术治疗。

Local relapse of anterior resection of rectal carcinoma in 42 cases was retrospectively analised in an attempt to discuss matters of its causes,diagnosis and reoperation. Of all the 42 cases,relapse occurred at the anastomotic stoma in 7 cases,relapse occurred at the pelvic cavity of the superior anastomotic stoma in 9 cases, occurred at the presacral region of the inferior anastomotic stoma in 14 cases,occurred at the lateral wall ＆ the anterior region of the pelvic cavity in 12 cases. The local relapse rate within the first 2 years, was 88.1%,the resection rate of secondary surgical treatment was 35.7%. It is revealed that local relaps occurred commonly within the first 2 years after operation, close follow up and rectal palpation may ensure the earlier diagnosis, and active surgical treatment is feasible in dealing with local relapse.