低位直肠癌保肛手术中直肠冲洗治疗对预后的影响

Effect of rectal washout on prognosis for low rectal cancer

目的研究低位直肠癌保肛术中应用直肠冲洗对预后的影响。方法随机选择98例低位直肠癌患者分为冲洗组(A组)和单纯手术组(B组),各49例。在经腹低位直肠前切除中,A组进行远端直肠冲洗并将冲洗液进行细胞学检查。将两组2年局部复发率和1、3、5年生存率进行比较。结果A组有27例找到癌细胞,术后局部复发率为14.3%,B组为30.6%,两组比较差异有统计学意义(P<0.05);A组术后1、3、5年生存率分别为96.8%、72.3%、52.3%,B组分别为95.7%、65.4%、43.0%,两组术后3、5年生存率比较,差异有统计学意义(P<0.05)。结论低位直肠癌保肛术中远端直肠冲洗是必要的,可以提高低位直肠癌的治疗效果。

Objective To evaluate the prognostic value of rectal douching for sphincter preservation in low rectal cancer. Methods 98 patients with low rectal cancer who underwent operations were selected and divided randomly into rectal douching group（group A,49 cases） and simple operative treatment group （group B, 49 cases）. In low anterior resection, the lavage fluid of the group A was collected and sent for exfoliative cytologic examination. The 1-, 3-, 5-year postoperative survival rate and 2-year locally recurrent rate were compared between the two groups. Results Cancer cells were found in twenty-seven in 27 cases（64.3%） of group A. 2-year locally recurrent rate were 14.3% in group A, while 30.6% in group B. The variation of 2-year locally recurrent rate between the two groups achieved statistical significance（P〈0.05）. The 1-, 3-, 5-year survival rates in group A were 96.8%, 72.3%, 52.3%. In group B were 95.7%, 65.4%, 43.0% respectively. The 3- and 5- year survival rates achieved statistical significance between the two groups （P〈0.05）. Conclusion Rectal douching is essential, it can improve the prognosis of sphincter preservation in surgery for low rectal cancer.