保留盆腔神经直肠癌前切除术并髂内动脉插管化疗临床疗效

Clinical Observation for Dixon' s Procedure with Pelvic Nerve Preservation Plus Internal Iliac Arterial Catheter Chemical Infusion.

目的探讨保留盆腔神经直肠癌Dixon术加双侧髂内动脉插管化疗术,术后病人生存率、生存质量、局部复发及性功能、排尿障碍等。方法 41例直肠前切除术,其中行全身化疗组24例,行保留盆腔神经+双侧髂内动脉插管化疗术组17例。结果行全身化疗组24例中,局部复发3例(12.5％),远处转移3例(12.5％),排尿障碍Ⅱ、Ⅲ级19例(79.2％),Ⅳ级4例(16.6％),无性功能22例(91.6％),5年生存率65％。行保留盆腔神经+双侧髂内动脉插管化疗术组17例中,局部复发3例(17.6％),远处转移3例(17.6％),排尿障碍Ⅱ、Ⅲ级4例(23.5％),Ⅳ级1例(5.9％),无性功能1例(5.9％),5年生存率61％。结论保留盆腔神经加双侧髂内动脉插管化疗与行直肠癌全身化疗组相比生存率无显著性差异P>0.05,但生存质量得到了大大提高。

Objective To evaluate Dixon' s procedure with the preservation of pelvic nerve plus bilateral internal iliac arterial cathefer chemical infusion and survival rate, life quality, local recurrence, sexual function and urination disorder of patients after operation. Methods 41 patients ware divided into two groups, 24 patients received general chemothrapy and 17 patients were treated with pelvic nerve preservation plus bilateral iliac arterial catheter chemical infusion. Results Local recurrence in 3 patients (12.5%K metastases in 3 patients (12.5%), urination dysfunction Ⅱ , Ⅲ grade in 19 patients (79.2% ), Ⅳ grade in 4 patients (16.6%), and no sexual function in 22 patients (91.6%) in the chemotherapy group Total 5- year survival rate is 65% in this group local recurrence in 3 patients (17.6%), metastases in 3 patients (17.6%), urination dysfunction Ⅱ , Ⅲ grade in 4 patients (23.2%), Ⅳ grade in 1 patient (5.9%) and no normal sexual fwmetion in 1 patients (5.9% ) in other group Total 5 - year survival rate is 61 % in that group. Conclusions There is no significant difference between two groups (P > 0.05), but life qulity of the second group has been greatly improved.