直肠系膜全切除与阴道切除在女性低位直肠癌根治术中的应用体会

RESEARCH IN VALUE OF TOTAL MESORECTUM EXCISION(TME) AND VAGINA RESECTION IN RADICAL SURGERY ON FEMALE LOWER RECTAL CANCER

目的 :探讨直肠系膜全切除与阴道切除在降低女性低位直肠癌局部复发中的价值。方法 :回顾性总结 43例女性 DukesB- C期低位直肠癌病例 ,其中 2 2例按 TME原则行直肠癌根治术 (含阴道全部或后壁切除 ) ,2 1例按传统直肠癌根治术 (未切除阴道 )。结果 :TME组 2 2例术后 2年内局部复发率为 4.5 5 % (1/2 2 ) ,阴道后壁肌层癌组织检出率 5 0 % (11/2 2 ) ,直肠系膜有癌率 6 3.6 4% (14/2 2 )。传统组 2 1例术后 2年内局部复发率为 2 3.6 7% (5 /2 1) ,直肠系膜有癌率 38.10 % (8/2 1)。结论 :TME加阴道切除能降低女性 Dukes B- C期低位直肠癌患者的局部复发率。

Objective:This paper is to elucidate the value of total mesorectumexcision(TME) and vagina resection in reducing the local recurrence of female lower rectal cancer Methods:A retrospective summary was made on 43 cases of female lower rectal cancer in Dukes B C stage,22 cases were radically operated on according to the TME doctrine and total vagina or the posterior wall of vagina were resected The other 21 cases were operated according to the traditional radical operation and without vagina resection Results:During the 2 years after operation,the local recurrence rate of the TME group is 4 55%(1/22),(11/22)cancer tissue found in the muscular layer of vagina posterior wall is 50%(11/22),and the rate of cancer tissue found in the mesorectum is 63 64%(14/22) In the traditional operation group,the local recurrence rate in 2 years after operation is 23 67%(5/21),and the cancer tissue was found in 38 10%(8/21)cases in the mesorectum Conclusions:TME and vagina resection can reduce the local recurrence in female lower rectal cancer in Dukes B C stage