265例低位直肠癌手术切除和保肛治疗的报道

Experience of sphincter-saving operation in the treatment of 265 cases with low rectal carcinoma

目的 探讨低位直肠癌保肛手术的局部复发和远期疗效。方法 对 1 991年 1月～ 1 998年 1月在我院行外科手术治疗的低位直肠癌 (肿瘤下缘距肛缘 5～ 6cm)进行回顾性分析 ,筛选出性别、年龄、肿瘤部位、病理组织学类型、Dukes分期、术前术后治疗情况等均无显著差异 (采用卡方分析、多因素统计法分析 ,P >0 .0 5 )的 5 33例病例 ,其中保肛手术组 2 6 5例、Miles手术组 2 6 8例。结果 保肛手术组 2年局部复发 1 2例 (4 .5 2 % )、5年生存 1 96例 (73.96 % ) ;Miles手术组 2年局部复发 1 3例 (4 .85 % )、5年生存 2 0 0例 (74 .6 2 % )。两组无显著差异 (P >0 .0 5 )。结论 本研究提示 :在严格掌握手术适应症的前提下 ,低位直肠癌行保肛手术是可行的。

Objective To study the long effects and local recurrence in sphincter saving operation of low rectal carcinoma.Methods From January 1991 to 1998,the low rectal carcinomas(5-6cm from the anus) operated in our hospital were analyzed retrospectively,there was no any significant difference in sex,age,site of tumor,type of pathology,staging of Dukes,treatment of pre operation or pro operation( P >0.05).They were selected from 533 cases.Two hundred and sixty five cases underwent sphincter saving operation and 268 cases underwent Miles operation.Results The two year local recurrence and the five year survival of sphincter saving operation group were 12 cases(4.52%) and 196 cases(73.96%) respectively;Those of Miles operation group were 13 cases(4.85%) and 200cases(74.62%).There was no significant difference between two groups in two year local recurrence and five year survival ( P >0.05).Conclusion The research prompt that sphincter saving operation of low rectal carcinoma were possible.But the indication of operation should be strictly considered.