肛管直肠恶性黑色素瘤27例临床分析

目的:总结原发性肛管直肠恶性黑色素瘤的临床特征、诊断、外科治疗及预后。方法:回顾性分析我院1978-2005年收治的27例经外科治疗的肛管直肠恶性黑色素瘤病人的临床资料。结果:本组27例,占我院同期肛管直肠恶性肿瘤手术例数1.1%。主要临床特征:便血16例,肛门口肿物14例,排便习惯改变4例。手术方式:腹会阴联合切除术13例,局部广泛切除10例,局部切除2例,乙状结肠造瘘2例。全组病例3年生存率18.5%,5年生存率11.1%。结论:肛管直肠恶性黑色素瘤是一种恶性程度极高的疾病,早期诊断及治疗相当重要,局部广泛切除术创伤小,可提高患者生活质量,不降低生存时间。

Clinical analysis of 27 patients with anorectal malignant melanoma

Objective:To summarize the clinical features,diagnosis and surgical treatment and prognosis of anorectal malignant melanoma(ARMM).Methods: Clinicopathologic data of 27 patients with ARMM admitted from 1978 to 2005 in our hospital were analyzed retrospectively.All 27 patients received surgical treatment.Results: The 27 patients with ARMM accounted for 1.1% of all the patients diagnosed as malignant tumors of anorectal simultaneously in our hospital.The most common complaints of patients were hematochezia(16/27),local mass(14/27),changing in bowel habits(4/27).Of these,13 cases underwent abdomino-perineal combined excisions,10 cases underwent transanal wide local resections,2 cases underwent local resections and 2 cases underwent sigmoid colostomy.3-year survival rate of the 27 patients was 18.5%,and 5-year survival rate was 11.1%.Conclusion: Anorectal malignant melanoma is an aggressive malignant tumor.Early diagnosis and treatment are extremely important.Local excision has the advantage of extensive trauma,it does not reduce the survival rate,and it can also improve the quality of life of patients.