Mason手术在中下段直肠癌局部切除术中的应用价值

目的探讨Mason手术在中下段直肠癌局部切除术中的应用价值.方法对本院近14年来采用Mason手术作局部切除的54例中下段直肠癌病例进行回顾性分析.结果Tis期癌17例,T1期癌20例,T2期癌15例,T3期癌2例.所有标本切缘经病理检查未发现癌残留.平均随访期为66个月.5年存活率为95%.术后局部复发1例(1.9%).术后无肛门失禁发生,伤口感染和直肠皮肤瘘各2例(3.7%).结论Mason手术是中下段直肠癌局部切除术的理想术式.术前高质量的肠道清洁准备,术中正确处理肛门外括约肌的切断与修复,完整彻底地切除肿瘤,是该手术成功的关键.

The value of Mason procedure for local excision of middle and lower rectal cancers

jective To investigate the value of Mason procedure for local excision of middle and lower rectal cancers . Methods Fifty-four patients with carcinoma of middle and lower rectum were treated by Mason surgical procedure for local excision within the last 14 years in our hospital. Clinical data was analyzed restrospectively. Results Tumors were in Tis stage in 17 patients, T1 stage in 20, T2 stage in 15, T3 stage in 2. No patients were diagnosed with positive margins upon final pathology of resected specimens. All patients were followed-up for an average of sixty-six months. The 5-year survival rate was 95 % . Local recurrence after operation was discovered in one patient (1.9%). No patient developed fecal incontinence. Wound infection and rectal fistula occurred in 2 patients (3.7%) respectively. Conclusion Mason procedure is a safe and effective method used for local excision of middle and lower rectal cancer. Excellent preoperative intestinal preparation, accurate intraoperative incision and repair of sphincter ani externus, complete excision of tumor are the keys to a successful Mason procedure.