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目的 探讨大肠癌术后复发的原因及诊断和治疗方法。方法 回顾性分析1998～2002年46例(48处)大肠癌术后复发的原因。结果 吻合口处复发13例，盆腔内复发15例，会阴部复发6例，肝脏转移7例，腹腔内复发7例。手术后2年内复发35例(76％)。本组病例均再次行手术治疗，其中28例直肠癌和18例结肠癌根治性切除率分别为54％(15／28)和67％(12／18)，姑息性切除率分别为4696(13／28)和3396(6／18)。结论 首次手术应根据大肠癌生物学特点，制定合理的以手术为主的综合治疗方案。切除足够的肠管、彻底清除淋巴结及其所在的肠系膜、杀灭微小转移灶，是预防大肠癌术后复发的主要措施。对复发病例应根据复发部位、病期早晚选择以手术为主的综合治疗方案。

Clinical analysis of recurrent colorectal cancer

Objective To study the causes of local recurrence ,diagnosis and treatment for recurrent colorectal cancer. Methods Forty-six cases of postoperative colorectal carcinoma recurrence were retrospectively analyzed. Results Recurrence in anastomotic stoma,pelvic cavity and perineum were in 13,15 and 6 cases respectively.Seven cases had liver metastasis,and another 7 cases were found recurrence in bdominal cavity. Among them 35 cases (76 %) had recurrence within 2 years after operations. Of 46 recurrent cases reoperated,curative surgery rate was 54%(15/28) and 67%(12/18) respectively,and palliative operation rate 46%(13/18) and 33%(6/18) for 28 rectum and 18 colon cancer cases. Conclusion For the first surgery,based on biological features of colorectal cancer we should make reasonably integrative therapy strategies,of which surgical treatment is the major means.Resecting intestine of primary lesion enough,performing complete lymphadenectomy and eradicating peritoneal exfoliated cancer cells and micrometastatic lesions completely are the major measures to prevent recurrence colorectal cancer after operation. Integrative therapy schemes,of which surgical treatment is the major means,should be considered according to the site of recurrence and the staging for the recurrence cases.