直肠癌前切除术安全下切缘的临床病理分析

目的:探讨直肠癌低位前切除术肿瘤逆向浸润与下切缘的安全距离的关系,观察切缘对局部复发率和生存率的影响。方法:选择距肛缘≤8cm的直肠癌行低位直肠前切除术患者45例,全部病例均行全直肠系膜切除术(TME)。对肿瘤下缘0.5cm、1.0cm、2.0cm、3.0cm的肠壁及系膜进行常规病理切片检查,镜下观察肿瘤组织有无浸润与转移。结果:45例直肠癌切除标本距肿瘤下缘0.5cm、1.0cm、2.0cm、3.0cm肠壁及系膜内病理组织学检查,下缘0.5cm见癌组织3例,其余下切缘病理组织学检查均为阴性。结论:直肠癌逆向浸润与转移未发现>1cm,因此认为直肠癌保肛术切除距肿瘤2.0cm的肠管和相应的系膜,下切缘是安全的。

Objective：To investigate the low anterior resection of rectal cancer with tumor reverse infiltration with cutting edge security distance, analysis of margin for the local reurrence rate and survival effects. Method： selection from the anal margin less than or equal to 8cm rectal cancer underwent low anterior resection for rectal cancer 45 eases, all cases were treated with total mesorectal excision （TME）. On the inferior margin of the tumor 0. 5era, lcm, 2cm, 3cm of the bowel wall and mesentery for routine patho- logic examination, microscopic tumor tissue with or without invasion and metastasis. Re- suits ：of 45 eases of rectal carcinoma resec- tion specimens from the inferior margin of the tumor 0.5cm, 1 era, 2cm, 3cm intestinalwall and mesentery in histopatho｜ogica｜ ex- amination,lower margin of 0.5cm see canc- er tissue in 3 cases, the rest of the cutting edge of histopathological examination were negative. Conclusion：the invasion and metastasis of rectal cancer reverse not found 〉 1 cm, so that the rectal carcinoma resection of tumor 2cm from the intestine and corre- sponding system membrane, the cutting edge is safe.