直肠癌保肛术后复发的外科治疗

目的探讨直肠癌保肛术后局部复发的原因、早期诊断及合理的外科治疗方法。方法回顾性分析我院1998年1月~2005年2月直肠癌保肛术后复发15例的临床资料。结果局部复发6例,吻合口周围组织复发4例,盆腔及脏器浸润5例。术后1年内复发10例,2年内复发14例。临床根治性切除率为40%。结论初次手术时,必须按照根治性原则彻底切除原发灶及其周围组织。对于复发的病例,应对病人的情况进行综合分析,采取积极的以手术治疗为主的综合治疗方案,以延长病人的生存期。

Surgical treatment of recurrence after anus-preserving rectal carcinoma resection

Objective To study the causes of recurrence,diagnosis and treatment of anus-preserving rectal carcinoma resection.Methods The clinical data of the recurrence in 15 cases of rectal cancer undergoing anus-preserving rectal resection from 1998 to 2005 were retrospectively analyzed.Results Local recurrence,recurrence around the anastomotic tissue and invasion of pelvic cavity or perineum occurred in 6 cases,4 cases and 5 cases respectively.There were 10 cases and 14 cases of postoperative 1-and 2-year recurrence respectively.Radical resection rate was 40%.Conclusion To decrease the postoperative local recurrence of rectal carcinoma and increase survival rates,primary lesion and its surrounding tissue must be radically resected,and lymphade-nectomy should be performed thoroughly.The recurrent rectal carcinoma still needs active surgical treatment in order to prolong the survival time and improve quality of life.