盆腔脏器切除术治疗复发直肠癌的效果观察

目的:探讨盆腔脏器切除术治疗复发直肠癌的效果。方法:回顾性分析1990年9月～2007年5月54例直肠癌术后复发患者的临床资料,其中42例再次手术,手术组中盆腔脏器切除术20例、姑息性复发病灶切除术22例,12例行非手术治疗。结果:姑息手术与非手术患者5年生存率分别为13.6%及0%,盆腔脏器切除术患者的5年生存率为40.0%,且均获得R0切除(肿瘤周围及切缘镜下未见癌残留)。结论:盆腔脏器切除术是治疗复发直肠癌的有效方法,严格选择病例,掌握手术适应证,确保获得R0切除,是获得满意疗效、减少术后并发症的关键。

Clinical Study of Pelvic Exenteration in the Treatment of Recurrent Rectal Cancer

Objective:To investigate the effect of the pelvic exenteration for the treatment of recurrent rectal cancer.Methods:Clinical data of 54 patients with recurrence of rectal cancer between 1990 and 2007 were analyzed retrospectively.Of the 54 cases,42 cases were re-operated.Another 20 cases received pelvic exenteration,22 cases received palliative operation and 12 cases did not have operations.Results:The 5-year survival rate in palliative operation group and none operation group were 13.6% and 0%,The 5-year survival rate in pelvic exenteration group were 40.0%.Patients of pelvic exenteration in the group of received R0 resection(with no tumor remains found around).Conclusion:Pelvic exenteration is an effective way of treating the recurrent rectal cancer.Choosing cases and operation indications strictly and Ro resection are the is the key factors in improving the therapeutic effects and decreasing the complication rate after operation.