直肠癌扩大根治术的临床研究

目的通过临床病理学研究,证实直肠癌扩大根治术的合理性,从而指导直肠癌的治疗.方法对进展期直肠癌进行三方向淋巴结清扫,以常规病理学方法研究淋巴转移规律,并以此规律指导临床进行扩大根治手术,统计分析其治疗效果.结果中国人进展期直肠癌淋巴转移率为45.0%,转移度为7.5%,上方第1,2,3站转移率分别为44.0%、14.0%和10.0%,侧方第3站转移率为9.0%.直肠癌淋巴转移与肿瘤侵袭周径、深度及病理学类型有关.扩大根治术后的5,10年生存率分别为68.0%和47.0%,高于一般根治术的45.0%和39.8%.侧方转移者的5年生存率达48.1%.结论直肠癌扩大根治术清除了可能发生转移的全部淋巴结,减少了转移淋巴结残留,可明显提高生存率,是比较理想的手术方式.

Clinico-pathologic study on extended radical resection for rectal cancer

Objective To justify clinico pathologically the extended radical resection for rectal cancer.Methods Resected lymphatic specimens obtained by the triple approach in the radical resection for advanced rectal cancer was studied by routine pathological method. The outcome of this extended radical resecition, guided by the route of lymphatic meatastasis are presented in the justification. Results The incidence of lymphatic metastasis in advanced rectal cancer in the Chinese was 45.0%, with 44.0%, 14.0%, 10.0% and 9.0% in the upper 1, 2, 3 and the lateral third groups. Lymphatic metastasis from rectal cancer was related to the extent, depth and pathological type. The 5 and 10 year survival rates were 68.0% and 47.0%, which are much higher than those of the conventional radical resection. Conclusion Extended radical resection for the rectal cancer, removing all the lymphatics,is able to prevent possible metastasis, thereby improving the survival rate significantly. This extended radical resection is an optimal type of operation.