老年性低位直肠癌的保肛治疗临床分析(附20例报告)

Anus preservation operation for low rectal cancer in elderly patient:A report of 20 cases

目的探讨75岁以上高龄低位直肠癌的临床特点及保肛手术。方法回顾性分析207例经手术和病理证实的75岁以上高龄低位直肠癌患者临床资料。结果207例均行手术治疗,其中182例(89%)属经腹根治性切除术,25例行结肠造口术。总切除率为96.1%。28例患者术后发生不同程度的并发症,占13.5%。手术死亡病例4例。3年生存率:miles术者为68%,Dixon术者为63%,两组比较差异无显著性。结论对高龄低位直肠癌患者应采取个体化治疗方案,低位直肠癌患者肿瘤下缘距肛直环1.5cm、肿瘤为高、中分化,术前指诊肿瘤可推动,肿瘤侵犯肠壁不到1周者可行保肛手术。

Objective To explore the clinical effects of anus preservation operation for low rectal cancer in the elderly patient. Methods The clinical data of 207 elderly patients with low rectal cancer were retrospectively analyzed. Results All the patients underwent surgical treatment. A total of 182 patients {89%} underwent low anterior resection （LAR）, 25 underwent abdominoperineal resection （APR}. Overall resectable rate was 96. 1%. Postoperative complications were recorded in 28 （13.5%） patients. Four patients died after surgery. Comparing the 3-year survival rate, patients underwent APR was 68%, and patients underwent I.AR was 63% （ P〉0.05）. Conclusion Individualized treatment should be taken for elderly patients with low rectal cancer. Age is not an independent negative prognostic factor for elderly patient with low rectal cancer.