直肠癌保留肛门括约肌手术适应症选择及预后分析

目的探讨直肠癌保留肛门括约肌手术适应症的选择标准并分析手术方式对患者预后的影响。方法选取2008年1月至2011年12月来我院就诊的直肠癌患者153例作为研究对象，其中行经腹会阴切除术患者52例，保留舡门括约肌手术患者101例，回顾性分析所有研究对象的临床资料，并比较分析直肠癌患者采取不同手术方式对患者生存率的影响。结果手术方式的选择与肿瘤发生部位、环周度、淋巴结转移、组织学类型、侵犯脏器、大体类型、是否为根治性、Dukes分期有关，两组患者的术后并发症发生率、术后局部复发率、排便功能、5年生存率方面差异无显著性。结论严格掌握手术适应症的前提下，直肠癌患者可以行保留肛门括约肌手术，而手术方式的本身并不影响患者的预后。

Indications and prognostic analysis of sphincter preservation operation for rectal cancer

Objective To study the indications of sphincter preservation operation for rectal cancer, and to analyze the effect of operation method on prognostic of patients. Methods A total of 153 cases with rectal cancer were enrolled into this study in our hospital from Jan. 2008 to Dec. 2011. All the subjects were divided into two groups： sphincter preservation operation for rectal cancer group （n=101） and abdominoperineal resection group （n=52）. Clinical data of all the subjects were analyzed retrospectively, and clinical pathologic parameters and 5-year survival rate were also compared and analyzed. Results Indications of sphincter preservation operation for rectal cancer were tumor location, infiltrated circumference of intestine, lymph node metastasis, histologic type, infringed viscera, general types, and differentiation degree. Conclusion Sphincter preservation operation can be considered as primary choice for rectal cancer, but it should be followed the indications. Operation method did not effect on the prognostic of patients with rectal cancer.