保肛手术治疗低位直肠癌53例临床分析

Clinical analysis in 53 cases of lower rectal carcinoma with sphincter-preserving operation

目的探讨低位直肠癌实施保肛手术的治疗方法及可行性。方法回顾性研究我院自2001年1月-2006年12月收治的53例患者行保肛手术的临床资料。结果随访1年～5年,吻合口复发3例,盆腔复发1例,局部复发率7.55%。因肝转移死亡4例,脑转移死亡2例,术后1,3,5年生存率分别为100%,88%,70。%结论影响低位直肠癌保肛术后生存率的主因是血行转移,而不是局部复发。低位直肠癌实施全直肠系膜切除及扩大淋巴结清扫,在保证根治前提下,合理选择手术适应证,积极实施保肛手术是可行的。

Objective To discuss the implementation of low-rectal cancer surgery treatment and feasibility.Methods Clinical data in 53 cases of patients with rectal surgery were retrospectively analyzed in our hospital from Jan.2001 to Dec.2006.Results Follow-up 1 to 5 years,anastomotic relapsed in three cases,one case with pelvic recurrence, the local recurrence rate was 7.55 percent.Four cases of death due to liver metastases,and two cases of metastatic brain died after one year,three years,the 5-year survival rates were 100%,88% and 70%.Conclusion Impact of low-rectal cancer survival rate after blood is the main reason for the transfer,rather than local recurrence.The implementation of low rectal cancer total mesorectal excision and expanding lymph node dissection,in ensuring radical premise,a reasonable choice surgical indications,actively implement the anal-operation is feasible.