局部复发直肠癌再手术适应证及手术方式的选择

Reoperation for locally recurrent rectal cancer:indication and choice of surgical procedure

局部复发直肠癌病情复杂,治疗难度大。再次行根治性切除术后其5年存活率可达到30%,但由于创伤大、并发症多,有时甚至可能加速病人的死亡,故应严格掌握其适应证。手术适应证和手术时机的把握,应该根据复发的类型、部位、病人的全身和局部情况、术者医院和术者本身经验等条件综合决定,采取既积极、又慎重的态度,以期给病人带来最大的利益。

Locally recurrent rectal cancer is difficult to be managed. The 5-year overall survival rate is reported to be as high as 30% if complete resection （R0） had been achieved in reoperation. The reoperation should be strictly confined due to its severe trauma and multiple complications which would even lead to sooner death. It is strongly recommended that, to benefit the patients, the determination of indication and time of reoperatlon should be initiative and prudent, depending on the type and location of recurrence, extent of recurrent lesions, general condition of patients and the corresponding experience of the surgeon, and the hospital.