直肠癌根治术后局部复发再手术35例分析

目的探讨直肠癌根治术后局部复发再手术的适应证及手术方法。方法对上海交通大学医学院附属新华医院普通外科1998年1月至2002年12月间收治的35例直肠癌根治术后局部复发的患者进行再手术治疗，并对其疗效进行回顾性分析。结果本组患者根治性切除19例（54.3％），姑息性切除11例，剖腹探查或单纯造瘘5例。根治性手术、姑息性手术及未切除患者的5年生存率分别为35．3％、18．2％和0，中位生存期分别为45个月、22个月和9个月。结论 对于局部复发性直肠癌，积极再手术能有效延长患者的生存期和提高生存率。

Analysis of reoperation in 35 cases of locally recurrent rectal cancer

Objective To explore the indication and the procedure of reoperation in patients with locally recurrent rectal cancer. Methods Clinical data of 35 patients with locally recurent rectal cancer from January 1998 to December 2002 undergone reoperation were analyzed retrospectively. Results Among the 35 cases, 19 underwent radical resection, 11 palliative resection and 5 colostomy (or laparotomy). The 5-year survival rates of the radical, palliative and colostomy (or laparotomy) were 35.3%, 18.2% and 0 respectively. Median survival time was 45, 22 and 9 months respectively. Conclusion Optimal reoperation for the patients with locally recurrent rectal cancer can improve the survival rate and quality of life effectively.