全盆腔脏器联合切除术治疗晚期直肠癌

Pelvic Exenteration for Locally Advanced Rectal Carcinoma

目的 :探讨提高晚期直肠癌的外科治疗经验及效果。方法 :对 1991～ 2 0 0 0年 15例局部扩散的直肠癌患者进行了全盆腔脏器联合切除术 ,并分析其远期疗效。结果 :本组手术根治性切除率 86 7% ,手术并发症发生率 13 5 % ,3年生存率为 75 % ,5年生存率为 5 0 %。结论 :盆腔脏器联合切除术为局部扩散的晚期直肠癌患者提供了根治性再切除的机会 ,延长了生存期。严格的病例筛选、对尿路改道的技巧性操作以及盆底腹膜的妥善修复是保证手术成功。

Objective:To explore the experience and results of surgical treatment for locally advanced rectal carcinoma.Method:Pelvic exenterations were carried out on 15 patients with locally advanced rectal carcinoma from 1991 to 2000,and the survival rate was estimated.Result:In our group,The radically resect rate was 86.7%,and the operative complication rate was 13.5%.The 3-year survival rate was 75%,and the 5-year survival rate was 50%.Conclusion:Pelvic exenteration may improve the survival rate for locally advanced rectal carcinoma.Urinary reconstruction and repair of pelvic peritoneum were important for reducing operative complications.