直肠癌术后局部复发及其外科处理

LOCAL RECURRENCE OF RECTAL CANCER AND ITS SURGICAL TREATMENT

目的探讨直肠癌术后局部复发原因及治疗问题。方法对４１例直肠癌术后局部复发作回顾性研究。分析了直肠癌术后局部复发时间，局部复发部位，治疗情况和预后。结果本组患者中２４例首次手术为直肠经腹低位切除术（Ｄｉｘｏｎ＇ｓ术），其中１８例为吻合口复发，６例为盆腔复发。１７例首次手术为经腹会阴联合切除术（Ｍｉｌｅｓ＇术），均为会阴部复发。３２例（７８．０％）于术后２年内复发。本组３２例再次行根治性手术，术后无瘤生存１年内１１例，２年内６例，５例无瘤生存３年以上。

URPOSE To investigate the causes of local recurrence of rectal cancer and methods of therapy.METHODS 41 cases of local recurrent rectal cancer patients were retrospectively studied.The time and locatiom of local recurrence,surgical treatment and prognosis were analysed.RESULTS In the group,24 cases were after Dixons operation,among them,18 were anastomotic recurrence,6 were pelvic failure;17 patients recurred after Miles procedure,all of them were perineal recurrence.32 cases(780%) were local recurrence 2 years after the original resection.Curative operation were done in 32 cases.11 patients were still alive with no tumor in 1 year,6 patients in 2 years and 5 patients were over 3 years.CONCLUSION Operation is the treatment of choice