腹膜返折以下进展期直肠癌功能性扩大根治术的临床意义探讨(附82例分析)

Clinic significance discussion of extended radical resection with pelvic autonomic nerves preservation in advanced rectal cancer under peritoneal reflection:Analysis of 82 cases

目的探讨腹膜返折以下直肠进展期癌患者行功能性扩大根治术的临床意义。方法对行扩大根治术治疗的82例腹膜返折以下进展期直肠癌患者的临床资料进行回顾性分析。结果50例行侧方淋巴结清扫者的3年局部复发率和5年生存率显著高于32例未清扫者(P<0.05),前者中,保留植物神经组的排尿功能恢复与性功能情况均优于未保留组(P<0.01),而5年生存率与未保留者相仿(P>0.05)。结论功能性扩大根治术既能提高患者的生存率、降低局部复发率又能改善患者的生活质量,是腹膜返折以下进展期直肠癌的理想术式。

Objective To explore the clinical value of extended radical resection with pelvic autonomic nerves preservation in advanced rectal cancer under peritoneal reflection. Methods The clinic data of 82 patients with advanced rectal cancer under peritoneal reflection underwent extended radical resection were analyzed retrospectively. Results Fifty patients were done side lymphadenectomy and the 3-year local recurrent rates and 5-year survival rates after operation were better than those of patients who have not done （P〈0.05）, In the side lymphadenectomy group. Thirty-two patients pelvic autonomic nerves had been preserved and their post-operative dysfunction of urination and sex were better than that of patients who have not been （P〈0. 01） and the survival rate has not been affected （P〉0.05）. Conclusion Extended radical resection with pelvic autonomic nerves preservation is the most optimized operation for advanced rectal cancer under peritoneal reflection, for it could prolong survival period, decrease the local recurrent rates and improve the survival quality.