低位直肠癌术式的选择及其疗效评价-肿瘤防治研究.PDFVIP

肿瘤防治研究 2005 年第 32 卷第 7 期 4·25 · 低位直肠癌术式的选择及其疗效评价 1 1 2 熊治国 ,张克亮 ,夏和顺 Comparison of Local Recurrence Rate and L ivabil ity of Low Rectum Cancer af ter Opera tion XION G Zhiguo 1 ,ZHAN G Keliang1 , XIA Heshun2 1. D ep t. of Gene ral S u rg e ry an d Urology , H ubei Cance r H osp i t al , W uhan 430079 , Chi na; 2 . D ep t. of P at hology Abstract :Objective 　To comp are local recurrence rat e (L RR) and 5year livabilit y of t hree different op er ation s on low rect um cancer wit h or wit hout anal sp hinct er p reservation and to di scu ss t he choice among t hem t hree . Methods 　 The hi story of 254 p atient s wit h low rect um cancer wa s collect ed and divided into t hree group s dep ending on t he met ho d of sur gical t reat ment . St udy t heir L RR and 5year livabilit y ret ro sp ectively . Results 　Local exci sion group , 32 p atient s ; Dixon wit h Tot al Mesorect al Exci sion ( TM E) group , 192 p atient s ; Miles wit h TM E group , 30 p atient s. The tot al rat e of anal sp hinct er p reservation i s ( ) 88 . 2 % 224/ 254 , and t he L RR of t umor in group 1 i s 15 . 0 % wit h 5 recurrent ca ses in 2 year s and 100 % 5year livabilit y ; 16 . 7 % in group 2 wit h 32 recurrent ca ses and 75 . 5 % 5year livabilit y , 20 % in group 3 wit h 6 recurrent ca ses and 47 . 7 % 5year livabilit y . There i s no st ati stic difference between t heir L RR ( P 0 . 05) . Conclusion 　We choo se different op eration met ho d accor ding to t he size of t he t umor , p at hologic st yle and t he Duke st age of t he low rect um cancer . Op eration s wit h anal sp hinct er p reservation were cho sen in mo st ca ses. Miles i s no longer t he havetodo op eration on p atient s wit h low rect um canc er . Key words : Low rect um cance