直肠癌前切除术后局部复发的防治

Prevention and Therapy of Local Recurrence after Anterior Resection of Rectal Cancer

目的 探讨直肠癌前切除术后局部复发的防治。 方法 回顾性分析 46例直肠癌前切除术后局部复发再手术患者的临床特点、治疗方法及防治措施。 结果 再次手术证实局部复发的病例中 ,吻合口复发 7例 ,吻合口周围组织局部复发 15例 ,直肠系膜复发 2 4例 ,予手术切除 2 7例 ,余 19例无法切除。 结论 局部复发与首次手术时未严格遵循无瘤操作原则、淋巴清扫不彻底、肠管切除不足、全直肠系膜切除不够等有关。把握好第一次手术术式的彻底性。

Objective To investigate the prevention and therapy of local recurrence after anterior resection of rectal cancer. Methods 46 cases who received reoperation for recurrence of rectal cancer after anterior resection were analyzed retrospectively. Results The reoperations revealed 7 local recurrences at the anastomotic stoma,15 local recurrences in the peripheral tissue adjacent to the anastomotic stoma and 24 recurrences of the mesorectun. Conclusion Local recurrence after anterior resection of the rectal cancer is closely related with the inadequate non-neoplastic technique,incomplete lymph nodes sweeping,insufficient resection of the distal normal part of the rectum,and insufficient total mesorectum excision. To prevent the local recurrence,performing the operation radically and keeping the tissue integrating during the dissection are the key points.