经骶尾部手术治疗高龄直肠癌患者低位保肛术后局部复发临床研究(附31例报告)

The clinical curative effect observation of 31 elderly patients with posterior resection of postoperative local recurrence of rectal cancer

目的探讨经骶尾部入路直肠肿瘤切除并横结肠双腔造口,治疗高龄患者直肠癌低位保肛术后局部复发的疗效。方法对2009年1月到2013年12月间收治的67例既往行低位直肠癌Dixon手术后局部复发的高龄患者(年龄>65岁),进行术前评估,其中的31例行经骶尾部入路直肠肿瘤切除并横结肠双腔造口,评价其手术根治性、安全性及疗效。结果所有31例患者均手术成功、达到切除目的,术后病理证实切缘阴性,术后无严重并发症,17例无瘤生存,总复发率45%。结论经骶尾部入路直肠肿瘤切除并横结肠双腔造口,治疗高龄患者直肠癌低位保肛术后局部复发的方法相对安全可行,让更多的高龄患者受益。

Objective To discuss the management for elderly local recurrent rectal cancer patients with posterior resection and colostomy.Methods From January 2009 to December 2013,to evaluate The efficacy,safety and operation of radical in 31 cases of patients in 67 patients of low rectal cancer patients（age65years）with local recurrence after Dixon surgery,have been treated with posterior resection and colostomy.Results All of the 31 patients were successful,to achieve the purpose of resection,postoperative pathology confirmed negative margin,no serious complications after operation,17 cases survived without tumor.Conclusion The method is relatively safe and feasible,that elderly patients benefit more.