摘要
目的:探讨局部复发性直肠癌再次手术治疗的疗效。方法:统计33例接受再次手术治疗的局部复发性直肠癌的临床资料,比较初次与再次手术的手术时间、出血量以及并发症,分析疗效以及影响疗效的因素。结果:33例中有23例(69.7%)行根治性切除术,10例行姑息性切除术。再次手术的手术时间长、出血多,吻合口瘘、肺部感染及伤口感染的发生率高,其中手术时间、出血量、肺部感率差异有统计学意义(P≤0.002)。全组1,2,3及4年生存率分别为96.8%、50.8%、28.6%及19.1%。根治性切除组的1,2,3及4年生存率分别为100.0%、65.4%、37.4%及24.9%,姑息性切除术组的1年和2年生存率分别为90.0%和20.0%,两组生存曲线比较差异有统计学意义(χ2=11.038,P=0.001)。年龄及再次手术后放化疗不是影响预后的主要因素。结论:对直肠癌术后局部复发患者,只要掌握好手术指征、严格选择患者、作好围术期充分准备和相应治疗,再次手术仍然能够获得良好效果。
Objective: To investigate effect of reoperation on locally recurrent rectal carcinoma. Methods:Collected the clinical data of 33 cases with locally recurrent rectal carcinoma, made a eomparision between primary operation and the second operation on operation time, blood loss and complication, analysed curative effect and in flueneing factors. Results: 23 (69.70%) cases accepted radical resection and 10 eases accepted palliative operation. With longer operation time and more blood loss, the second operation had a higher rate of stoma fistula, pulmonary infection and wound infection, and the differences of operation time, blood loss and pulmonary infection was statistically signifieant(P≤0. 002). The 1-, 2-, 3- and 4-year survival rate of total group were 96.8%, 50. 8% , 28.6% and 19. 1% respectively. The 1-, 2-, 3- and 4-year survival rate of radical resection group was 100.0% , 65.4% , 37.4% and 24.9% respectively, the 1- and 2-year survival rate of palliative operation group was 90.0% and 20.0% respectively, the difference of survival curve in two groups was statistically signifieant(Х^2 = 11. 038, P = 0. 001 ). Age and postoperationary radiotherapy-chems were not main influencing factors on prognosis. Conclusion: With strict operation indication, sufficient preopera preparation and energetic therapy, surgical treatment of locally recurrent rectal carcinoma can also obtain good effect.
出处
《海南医学院学报》
CAS
2009年第6期671-673,675,共4页
Journal of Hainan Medical University
基金
海南医学院科研基金资助项目(0020090031)~~
关键词
直肠
癌
外科手术
再手术
Rectal
Carcinoma
Surgery
Resurgery