直肠癌术后复发再手术治疗的临床研究

为了总结直肠癌根治术后复发再手术的诊断治疗经验,回顾性分析13例手术治疗的直肠癌术后复发患者的临床资料,并复习相关文献。13例患者中,随访11例,失访2例。随访满1、3和5年者分别为11、9和2例,生存1、2、3和5年者分别为2、5、2和2例,生存>5年者2例。死亡的患者中,心肌梗死1例,肝转移3例,肝转移并腹腔转移1例,肺转移2例,腹腔转移1例,局部复发并腹腔转移2例,脑血管意外1例。4例保肛患者,6个月后排便次数恢复至2~3次/d,1年后恢复至1~2次/d。初步研究结果提示,建立完善的随访机制和规范的随访检查是早期发现直肠癌复发的有效手段。准确的术前评估和选择合理的手术方式是预防并发症和治疗成功的关键。有效保留植物神经功能可显著提高患者术后的生存质量。

Clinical study of operation treatment for rectal carcinoma patients with recurrence after radical operation

The objective of this study was to summarize the diagnosis and treatment experience of operation treatment for rectal carcinoma patients with recurrence after radical operation.Thirteen rectal carcinoma patients with recurrence after radical operation were analyzed retrospectively,and the literature was reviewed.Eleven patients were followed up.Two patients survived for 1 year,5 survived for 2 years,2 survived for 3 years,2 survived for 5 years,and 2 survived for more than 5 years.One patient died of myocardial infarction,3 died of liver metastasis,1 died of liver metastasis plus celiac metastasis,2 died of lung metastasis,1 died of celiac metastasis,2 died of local recurrence plus celiac metastasis,and 1 died of cerebrovascular disease.Four patients could defecate 2-3 times everyday,6 months after operation of retention of anus,and 1-2 times everyday 1 years after the operation.In conclusion,perfect follow-up system is the effective method for early diagnosis of rectal carcinoma.Nicety evaluation before operation and right operation program are the key to prevent complication and succeed in operation.