直肠癌Miles术后局部复发原因及治疗

目的探讨直肠癌Miles术后局部复发的原因及防治。方法1986年1月至2001年12月共行直肠癌Miles手术168例，对其中术后局部复发27例的临床情况进行回顾性分析。结果局部复发27例中男性20例，平均年龄比首次手术组低5岁，Dukes C期19例，组织学高度恶性15例，肿瘤距肛门3～6cm 17例。复发再手术11例，5年生存率27．2％(3／11)。结论术后局部复发与年龄、性别、病期、病理类型、肿瘤部位及根治是否彻底密切相关。预防复发宜做好首次手术。对复发病例力争早发现再手术以延长生存期。

The reason of local recurrence and treatment after Miles operation for rectal cancer

Objective To discuss the reason of local recurrence,prevention and treatment after Miles operation for patients with rectal cancer.Methods In our hispital from Jan. 1986 to Dec.2001,27 recurrent cases of 168 patients after resection for rectal cancer were analysied.Results Among the recurrent cases,20 cases were male,with mean age of 48 years old the first diagnose age of total cases was 53 years;19 cases were in the stage of Dukes C;15 cases were with high malignant degree in pathological grading.There were seventeen patients with tumors at the distance of 3 to 6cm from anus adges.Eleven cases were re-operated and the 5-year survival rate was 27.2%(3/11).Conclusions The local recurrence after Miles operation is closely related with various factors such as age,sex,late stage cancer with high pathological grading malignanly degree,site of malignant tumor and completely operative treatment.A successful first operation can effectively prevent the recurrence.The recurrence cases should be treated early in order to prolong there life.