直肠癌全直肠系膜切除术与传统直肠癌根治术疗效对比研究

目的：探讨直肠癌全直肠膜切除术（TME）与传统直肠癌切除术的治疗效果。方法：对南方医院102例行TME手术治疗病人（TME组）和104例传统直肠癌根治术病人（传统手术组）进行临床分析。结果：TME组102例，其中75例行Dixon术，27例行Miles术；传统手术组104例，其中74例行Dixon术，30例行Miles术。TME组和传统手术组局部复发率分别为10．2％（10／98）和25．5％（75／98）（P＜0．01），1年生存率分别为96．0％（96／100）和92．2％（94／102）（P＞0．05），2年生存率分别为98．0％（96／988）和87．8％（86／98）（P＜0．05）。两组的泌尿功能障碍分别为2．0％（2／98）和36．7％（36／98），性功能减退分别为7．1％（7／98）和46．9％（46／98），勃起障碍分别为2．8％（2／71）和61．4％（43／70），射精障碍分别为2．8％（2／71）和64．3％（45／70），阴道疼痛分别为10．3％（3／29）和86．2％（25／29），两组差异均有统计学意义（P均＜0．001）。结论：与传统的直肠癌根治术相比，TME可减少术后复发和转移，并发症发生率也大大下降。

Curative effect comparison between total mesorectal excision and the traditional rectectomy for rectal cancer

Objective:To determine the effect of total mesorectal excision and traditional rectectomy.Methods:The treatment and follow-up were retrospectively analyzed in 102 cases of rectal cancer treated by the total mesorectal excision,and 104 cases of traditional rectectomy,and hospitalized from July 1999 to June 2002 in Nanfang Hospital.Results:Of 102 cases,Dixon procedure were performed in 75 cases,Miles procedure in 27 cases.Survival 98 cases,metastasis and recurrence in 10 cases,recurrence rate was 10.2%.Seven cases decreased in sexual function(7.1%),two cases were disordered in urinary function(2.0%).Of 104 cases,survival 98 cases,metastasis and recurrence in 25 cases,recurrence rate was 25.5%.Forty six cases decreased in sexual function(46.9%),thirty six [CM(139.9mm]cases were disordered in urinary function,the differences between two groups were significant(P<0.001).Conclusion:Total mesorectal excision for rectal cancer is an important treatment of the reduce metastasis and recurrence post-operation as compared with traditional rectectomy.