直肠癌全直肠系膜切除的适应证

目的 探讨直肠癌全直肠系膜切除（total mesorectal excision,TME)的适应证。方法 回顾分析132例根治性手术治疗的直肠癌患者的临床资料，比较不同肿瘤分期，肿瘤部位，是否行TME之患者术后2年复发率的差别。结果 Dures B期患者术后2年复发率明显低于Dukes C期患者（11．1％vs29.4%,x^2=7.046,P=0.008)；直肠癌行TME患者术后2年复发率显著低于非TME患者（10.%vs26.1%,x^2=5.471,P=0.019)，但直肠中上段癌患者行TME与否，术后2年复发率无明显差别，而直肠下段癌患者行TME与否，术后2年复发率有显著差别。结论 对直肠下段癌应行标准的全直肠系膜切除。

Indication of Total Mesorectal Excision in Rectal Carcinoma

Objective To investigate the indication of total mesorectal excision in rectal carcinoma. Methods The clinical data of 132 patients with rectal carcinoma who had radical operations were analyzed retrospectively.Results The two year recurrent rate of rectal carcinoma patients in Dukes B stage was significantly lower than that in Dukes C stage (11.1% vs 29.4%,P =0.008).The two year recurrent rate of rectal carcinoma patients with total mesorectal excision was lower than that without total mesorectal excision(10.4% vs 26.1%,P =0.019),and this difference was significant between the patients with low rectal carcinomas,but was not significant between the patients with up or mid rectal carcinomas.Conclusion The low rectal carcinoma should be treated with standard total mesorectal excision.