全直肠系膜切除术在直肠癌治疗中的应用研究

The study of total mesorectal excision for rectal cancer

目的比较全直肠系膜切除(TME)和传统手术方法对直肠癌术后局部复发及长期生存率的影响。方法将1999～2003年采用TME技术的直肠癌患者43例与1994～1998年行传统切除方法的41例患者进行比较,分析两组的临床病理参数。结果手术后并发症发生率无差异,TME组2年局部复发率为6.4%,明显低于对照组的32.2%。在TME技术、肿瘤的Dukes分期、患者的年龄、肿瘤距肛门的距离等因素中,TME、肿瘤的Dukes分期是独立的影响局部复发的指标。结论对于距离肛门12cm范围内的直肠癌,采用TME技术能有效地降低局部复发率。

Objective To compare the effect of total mesorectal excision （TME）and conventional surgical procedure in local recurrence and long - term survival. Methods From 1994, total mesorectal excision was used as a standard procedure for rectal cancer and consecutive patients treated with conventional surgical procedure from 1994 to 1998 as control. There were 43 patients in TME group and 41 in control group. Clinical and pathologic data were collected prospectively and analyzed. Results No significant difference in morbidity was found between the two groups. Local recurrence rate 2 years after operation was 6.4% in TME group and 32.2% in control group. Among factors such as TME, Dukes stages, patients＇age ,Tumors＇distance from anus, TME and Dukes stages were independent indicators for local recurrence. Conclusion As for the patients with rectal cancer less than 12cm from anus,TME can reduce local recurrence.