直肠癌Dixon术后局部复发60例临床分析

Clinical analysis of local recurrence in postresection of rectal cancer with Dixon(report of 60 cases)

目的 探讨直肠癌Dixon术式术后局部复发的相关因素及其防治措施。方法 对我院1984～1993年行Dixon术510例病人作一回顾性分析。结果 510例Dixon术式术后局部复发60例(11.8％),复发时间为术后3～20月,平均8.9月,1年内复发者45例。复发部位为吻合口46例,淋巴结5例,会阴部4例,吻合口周围3例,切口2例。Dukes A期者5例,B期37例,C期18例。粘液性腺癌占33例,低分化腺癌17例,印戒细胞癌6例,腺癌4例。肿瘤远切缘距离<3cm者48例,>3cm者12例。结论 直肠癌Dixon术式术后局部复发与肿瘤Dnkes分期、细胞学类型、远切缘距离、术前灌肠等多种因素密切相关。

Objective To discuss the relation and prevention of local recurrence postresection by Dixon in patients with rectal cencer.Methods 510 cases after resection for rectal cancer by Dixon in our hospital from 1984 to 1993 were analysed. Resits The local recurrence after Dixon operation was in 60 cases(11.8%), the recurrent time of postoperation was in 3 - 20 months,mean time was in 8.9 months.45 cases of recurrence were within 1 year.The recurrence occured at the anastomotic stoma (46 cases) and its surroundings (3 cases), lymph node (5 cases) ,perinum(4 cases) and incision (2 cases). Among the recurrent cases the pathological grading with Duckes A,B,C were 5 cases,37 cases and 18 cases respectively. Mucoid adenocarcinoma 33 cases, poor differentiated adenocarcinomal 7 cases, signet cell cancer 6 cases and adenocarcinoma 4 cases. Distance from tumors to operation edges was less than 3cm in 48 cases and more than 3cm in 12 cases. Conclusion The local recurrence after Dixon operation is closely related to various factors such as pathologic grading, cytologic type, distance from tumor to operation edge and pre-operative enemator.