全直肠系膜切除术在直肠癌治疗中的作用

目的探讨直肠癌全直肠系膜切除术(TME)的临床应用价值。方法对65例中下段直肠癌行TME,分析术后局部复发率、术后并发症、直肠系膜肿瘤残留情况。结果65例直肠癌局部复发率为7.7%(5/65),术后吻合口漏的发生率为6.2%(4/65),5例术后短期内有泌尿生殖功能障碍,无骶前大出血,术后病检报告系膜内有癌巢存在的有35例(54%)。结论TME是治疗中下段直肠癌必须遵循的原则,能明显降低局部复发率及术后并发症,提高保肛手术率。

Clinical value of total mesorectal excision in treating rectal carcinoma

Objective To discuss the clinical significance of total mesorectal excision(TME).Methods Sixty-five cases of rectal cancer were subjected to TME.The postoperative local recurrent rate,postoperative complication incidence and the residue of rectal mesentery tumor were analyzed.Results The local recurrent rate was 7.7% (5/65).The incidence of postoperative anastomotic leakage was 6.2%(4/65).Five patients had something trouble with urinary and lasted a short time after the operation,but no bleeding at sacrum.Postoperative biopsy revealed that 35 cases had cancer nests inside the mesoretum.Conclusion TME is the principle we must be followed in the treatment of middle and lower rectal cancer.It can effectively decrease local recurrent rate and incidence of postoperative complication.