直肠癌不同范围根治术效果分析

The effect analysis on the radical operation of variable range for carcinoma of rectum

目的 探讨浸润型直肠癌合理的根治性切除范围与术后效果。方法 对未发现肝脏及其他远处转移的浸润型直肠癌 ,在实施标准性根治术 315例 (简称单一手术组 )的基础上 ,又按Dukes’A、B、C不同分期分别实施缩小性根治术 (D2 ) 116例 ;标准性根治术 (D3) 4 6 0例 ;扩大性根治术 (D4 ) 199例 (称分期手术组 )。结果 排尿机能障碍单一手术组 2 76例 ,占 78% ;分期手术组 5 75例 ,占 6 0 1% (P <0 0 5 )。性机能障碍 (仅统计男性 )单一手术组 174例 ,占 83% (174 2 10 ) ;分期手术组 383例 ,占 76 3% (383 5 6 2 ) (P <0 0 5 )。复发率单一手术组为 4 4 8% ;分期手术组为 4 5 5 % (P >0 0 5 )。 5年生存率单一手术组为 5 5 9% ;分期手术组为 5 4 3% (P >0 0 5 )。结论 单一手术组和分期手术组复发率和 5年生存率无显著差别意义 。

Objective To investigate the proper eradicating range and the postoperative effect of the infiltrating carcinoma of rectum. Methods For the infiltrating cancer of rectum without the liver and beyond metastasis, on the basis of 315 cases undergone the standard radical operation(defined as single operative group), the shrunk radical operation(D 2) was performed on 116 cases by Dukes' A, B, C staging; the standard radical operations(D 3) was performed on 460 cases; the enlarged operations(D 4) was performed on 199 cases (as staging operative group). Results The urinary function affected: the single group was 276 cases and accounted for 78%; the staging group was 575 cases, for 60.1%(P<0.05). The sexual function harmed(only statistics of male patients): the single group was 174 cases, for 83%(174/210); the staging group was 383 cases, for 76.3%(383/562)(P<0.05). The recurrence rate: the single group accounted for 44.8%; the staging group was 45.5%(P>0.05). The 5-year survival rate: the single group was 55.9%; the staging group was 54.3%(P>0.05). Conclusions The recurrence rate and the 5-year survival rate of both groups showed no remarkable difference. The postoperative quality of life was advantage of the staging group over the single group.