不同时期低位直肠癌根治手术保肛率变化及其因素分析.docVIP

不同时期低位直肠癌根治手术保肛率的变化及其因素分析 　　[摘要] 目的 探讨低位直肠癌根治手术在不同时期保肛率的变化及其因素分析。 方法 将2003年7月～2008年6月收治的79例设为远期组，收治的2008年7月～ 2013年6月的104例设为近期组（采用全直肠系膜切除术）。根据所有患者是否施行保肛手术而分为ARP组45例和SP组138例。 结果 远期组和近期组两种不同手术方式比较，差异有统计学意义（P0.05）。SP术两组比较，差异有统计学意义（P0.05）。肿瘤周径1/2周～全周四者的保肛率依次下降，差异有统计学意义（P0.05）。肿瘤大体分型中，肿块型、溃疡型及浸润型及肿瘤病理呈高、中、低分化癌者三者的保肛率呈现依次下降的趋势（P0.05）。低位直肠癌Dukes A～D期四者保肛率也呈现逐渐下降的趋势。 结论 全直肠系膜切除术在一定程度上提高了低位直肠癌的保肛率。肿瘤周径、肿瘤病理分期、肿瘤主体位置、肿瘤大体分型、肿瘤分化程度及患者的性别及BMI等均可对低位直肠癌手术保肛产生影响。 　　[关键词] 不同时期；低位直肠癌；根治手术；保肛率；影响因素 　　[中图分类号] R653 [文献标识码] B [文章编号] 2095-0616（2013）24-212-03 　　Analysis on the changes and factors of anus preservation rate in anus-protection operation on low rectal cancer in different periods 　　HUANG Shishun WAN Deyan 　　Department of Surgery，Shanwei Yihui Foundation Hospital，Shanwei 516600，China 　　[Abstract] Objective To explore the changes and factors of anus preservation rate in anus-protection operation on low rectal cancer in different periods. Methods 79 cases during July 2003 to June 2008 were classified as the long-term group，while 104 cases during July 2008 to June 2013 were classified as the short-term group，the patients in the short-term group were treated with the total mesorectal excision.All patients were divided into 45 cases of group ARP and 138 cases of group SP according to whether or not undergo anus preserving operation. Results The difference was statistically significant between the early group and late group（P3/4 tumor diameter and total tumor diameter decreased by turns（P0.05），and that in mass type，ulcer type and infiltration type of tumor gross type and in high，medium， low differentiated carcinoma and in Dukes A，B，C，D phase of low rectal cancer also decreased by turns（P0.05）. Conclusion Total mesorectal excision improves the anus preservation rate of low rectal cancer at some extent.Tumor diameter， tumor staging，tumor location，tumor body gross type，tumor differentiation and sex of the patients and BMI can affect the anus-protection operation in low rectal can