保留盆腔植物神经的直肠癌扩大根治术

目的　研究保留植物神经的直肠癌扩大根治术在直肠癌手术中的意义并与传统术式比较。　方法将腹膜返折以下的直肠癌病人随机分为两组 :实验组行保留盆腔植物神经的直肠癌扩大根治术 ,对照组行传统的直肠癌根治术 (Dixon术或 Mile术 )。统计扩大根治术的淋巴结转移阳性率 ,对比两种术式对患者的影响、肿瘤复发率、3年生存率。　结果　实验组肿瘤淋巴结转移率为 2 2 .72 % ,转移度为 4 .0 5 %。两种术式在患者性功能及排尿功能上差异无显著性 ;两种术式在并发症上差异无显著性。实验组与对照组肿瘤复发率分别为 3/ 2 2 ,8/ 2 2 (P<0 .0 5 ) ;3年生存率分别为 2 1/ 2 2 ,16 / 2 2 (P<0 .0 5 )。　结论　腹膜返折以下的直肠癌应行保留盆腔植物神经的直肠癌扩大根治术 ,该术式既清扫了可能转移的淋巴结 ,又保证了患者的排尿及性功能

Protecting of Pelvic Splanchnic Nerve in the Operation of Rectum Carcinoma

Objective To study the significance of protecting of pelvic splanchnic nerve in the extensive radical operation rectum carcinoma. Methods The patients of rectum carcinoma from 1998~2001 were randomized into two groups: the experimental and the control. The experimental was given the protecting of pelvic splanchnic rectum cacinoma in extensive radical operation. The control was given the tranditional rectum carcinoma radical operation. The positive lymph nodes were analysed also. The effects of two styles of operation were compared. Results The positive rate is 22 72% in keeping splanchnic pelvis rectum carcinoma extensive radical operation. The difference in complication between two styles of operation was no significance. Conclusion The protecting of pelvic splanchnic rectum carcinoma in extensive radical operation is better than the tranditional rectum carcinoma radical operation when the tumor is below peritoneum folding.;