直肠癌术后局部复发的外科治疗

Surgical Management of Recurrence of Rectal Cancer

目的 探讨直肠癌术后局部复发的外科治疗。方法 回顾性分析 5 8例直肠癌根治术后局部复发患者的临床资料。结果 5 8例患者中再次手术 15例 ( 2 5 .8%) ,其中根治性切除 5例 ( 8.6 %) ,姑息性切除 6例 ( 10 .3%) ,单纯结肠造瘘 4例 ( 6 .9%) ,15例再手术患者的 3年、5年生存率分别为 46 .7%和 2 6 .7%,非手术切除治疗者的 3年、5年生存率分别为 6 .9%和 0 ,有非常显著性差异 (P <0 .0 1)。结论 直肠癌根治术后 2～ 3年内应严密随诊 ,对局部复发者再次行手术切除是首选的治疗方法。

Objective To investigate the surgical treatment for the postoperation local recurrence of rectal cancer.Methods 58 cases suffering from postoperative local recurrence of rectal cancer were analyzed.Results Among them 15(25.8%) patients received second surgical treatment,out of the 15 cases,5(8.6%) were treated by curative resection,6(10.3%) by palliative resection and 4(6.9%) by single colostomy.3 and 5 year survival rate was 46.7% and 26.7% respectively,wheras 3,5 year survival rate of the other patients without second resection was 6.9% and 0,there was significant difference between two groups(P<0.01).Conclusion The second operation is the first treatment for postoperative local recurrence of rectal cancer.