低位直肠癌术后局部复发的原因分析

Clinical analysis of local recurrence after radical resection for low rectal carcinoma

目的探讨低位直肠癌根治术后局部复发的原因。方法回顾1992年2月至2007年12月我院收治的低位直肠癌102例，行各式保肛术38例，Mile术64例，分析术后复发与临床病理、盆腔解剖特点及手术方式的关系。结果低位直肠癌根治切除术后局部复发率为26．47％（27／102）。局部复发与肿瘤病理类型（P=0．000）、肿瘤临床分期（P=0．000）显著相关，与手术方式（P〉0．05）无相关性。结论肿瘤病理类型、临床分期是影响低位直肠癌根治术后局部复发的重要因素。只要严格掌握手术适应证、术中遵循全系膜切除术（TME）原则，施行各式保肛术不会增加术后局部第发奎．

Objective To investigate the causes for local recurrence after radical resection for low rectal carcinoma. Methods Clinical data of 102 patients with low rectal carcinoma who were admitted to our hospital from February 1992 to December 2007 were retrospectively analyzed. Among the patients,38 underwent sphincter preservation operation and 64 Miles operation. The relationship between local recurrence and clinicopathological characteristics or resection methods was analyzed. Results The local recurrence rate after radical resection for low rectal carcinoma was 26.47% （27/102）. Local recur- rence was closely related to clinical pathological type （ P = 0. 000 ） and Dukes stage （ P = 0.000）, but not to the method of operation （P 〉 0. 05 ）. Conclusion Pathological type and clinical stage are the key factors that influence the local recurrence of low rectal carcinoma after radical resection. Various sphincter preservation operations dont increase local recurrence of low rectal carcinoma as long as the operation indication is strictly controlled and the principle of total mesorectal excision （TME） is followed.