低位直肠癌的手术治疗:附206例分析

Surgical treatment of lower rectal carcinoma:a report of 206 cases

目的 探讨低位直肠癌的术式选择及保肛手术的治疗效果。方法 回顾性分析 2 0 6例低位直肠癌病例的临床资料。结果 2 0 6例中行Miles手术 61例 ,各种保肛手术 14 5例。 14 5例保肛手术中术后发生吻合口瘘 16例 ( 11.0 % ,16/ 14 5 ) ,肛门狭窄 13例 ( 9.0 % ,13 / 14 5 )。无手术死亡。术后 5年生存率Miles手术为 62 .3 % ,保肛手术为 67.2 % (P >0 .0 5 )。结论 低位直肠癌的治疗可根据患者情况选用保肛手术或Miles手术。在保证根治的情况下 ,应尽可能选用保肛术。

Objective To explore the operative methods and the effect of ano- reserving operations for lower rectal carcinoma (LRC) .Methods Retrospective analysis was made on the clinical and pathological data of 206 LRC cases. Results Of the 206 cases, 61 cases underwent Miles operation, 145 received ano-reserving procedures (ARP). In the 145 cases treated with ARP, postoperative anastomostic leakage occurred in 16 cases (11.0%),and anus stenosis in 13 cases (9.0%). All the complications were cured by non-operative treatment. There was no operative death in this series. The postoperative 5-year survival rate in Miles operation was 62.3%, in ano-reserving procedures was 67.2%( P>0.05). Conclusions The choice of Miles opereration or ARP in the treatment of LRC is mainly according to patients condition. However, if a radical treatment can be assured. ARP is the best choice for LRC.