早期直肠癌内镜治疗术后补救性手术的临床分析

Salvage surgery after endoscopic treatment for early rectal cancer

目的探讨早期直肠癌内镜治疗术后补救性手术的必要性。方法回顾性分析2013年1月至2021年12月在苏州大学附属第一医院普通外科因早期直肠癌行内镜治疗后未达到治愈标准接受补救性外科手术的62例患者的临床资料。结果62例患者中6例(10%)患者有肿瘤残留,8例(13%)患者有淋巴结转移,1例(2%)患者有癌结节。平均手术时间(178±82)min。术后1例(2%)发生吻合口瘘,经保守治疗好转;2例(3%)发生肠梗阻,其中1例(2%)经保守治疗好转,1例(2%)再次手术后好转。结论对于有癌残留和淋巴结转移危险因素的早期直肠癌患者追加手术是必要的。

Objective To explore the necessity of salvage surgery after endoscopic resection of early rectal cancer.Methods The clinical data of 62 patients who underwent salvage surgery for early rectal cancer at the First Affiliated Hospital of Soochow University from Jan 2012 to Dec 2021 were retrospectively analyzed.Results Six cases(10%)had residual tumors,8 cases(13%)had lymph node metastasis and one case(2%)had cancer nodules;The operation time was(178±82)mins;1 case(2%)developed anastomotic lerakage,which was cured;2 cases(3%)developed intestinal obstruction,of which 1 case(2%)relieved on conservative management and 1 case(2%)underwent reoperation.Conclusion It is necessary to perform salvage surgery for early rectal cancer patients with residual caner and risk factors of lymph node metastasis after endoscopic therapy.