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目的 评价盆腔脏器联合切除术（PE）对局部进展期直肠癌的疗效。方法 对12年中79例局部进展期直肠癌PE术后结果进行回顾性总结。结果 全盆腔脏器切除术（TPE）46例，其中保肛TPE5例，TPE联合骶骨切除1例，TPE联合半骨盆切除1例，后盆腔脏器切除术（PPE）33例。根治性切除65例（82．8％），合并症发生率48．6％，手术死亡2例（2．5％），根治术后再复发36例（58．1％），术后1、3、5年生存率75．8％、39．3％、35．8％。根治性切除与大体根治切除术后3年、5年生存率分别为44．2％、40．8％与11．1％、0。结论 PE是目前治疗局部进展期直肠癌有效的方法，积极的根治性切除病灶，可以有效提高其治愈率，改善生活质量。

Significance of pelvic exenteration for locally advanced rectal cancer

Objective To evaluate the effect of pelvic exenteration for locally advanced rectal cancer. Methods Clinical data of 79 cases with locally advanced rectal cancer receiving pelvic exenteration were analyzed retrospectively. Results Of 79 cases,46 patients underwent total pelvic exeneration, including 5 patients with sphincter preservation, one patient with sacrectomy and one patient with hemipelvectomy;33 patients underwent posterior pelvic exenteration. Of 79 cases,65(82 3%)patients underwent radical resection, the total complication morbidity was 48 6%,the mortality was 2 5%(2/79),the recurrence was found in 58 1% of patients who had undergone radical resection. The postoperative 1-,3-,5-year survival rates were 75 8%,39 3% and 35 8%. The 3-,5-year survival rates in patients treated with radical resection and those with gross curative resection were 44 2%,40 8% and 11 1%,0% respectively. Conclusion Pelvic exenteration is an effective method in the treatment of locally advanced rectal cancer, aggressive radical resection can obviously increase the survival rate and improve the quality of life.