低位直肠癌不同切除范围的疗效分析

目的:探讨低位直肠癌全直肠系膜切除与侧方淋巴结清扫对局部复发率、生存率和术后生存质量的影响。方法:对426例低位直肠癌行根治性切除,其中241例行全直肠系膜切除,185例全直肠系膜切除 侧方淋巴结清扫。结果:无手术死亡病例,两组在性别、年龄、肿瘤肠壁的浸润深度、组织学类型等方面差异无显著意义。全直肠系膜切除组排尿功能障碍占5.8%,性功能障碍占13.2%;而侧方淋巴结清扫组分别是51.9%和51.9%(P<0.05)。局部复发率,全直肠系膜切除组DukesC期为23.5%,而侧方淋巴结清扫组为12.0%(P<0.05),5年生存率两组差异无显著性(P>0.05)。结论:低位直肠癌行侧方淋巴结清扫能降低术后局部复发率,但对术后生存质量有影响。

Analysis of the Effective of Different Clearance Scope for Lower Rectal Cancer

Objective: To study the relationship of local relapse rate,survival rate and quality of life with total mesorectal excision and lateral lymphadenectomy for lower rectal cancer.Methods: The radical operation were performed on 426 cases of lower rectal cancer.Among them,241 cases was performed total mesorectal excision and 185 cases coupled with lateral lymphadenectomy.Results: There were no death cases in both groups.Urinary function injury,in total mesorectal excision group accounted for 5.8%,51.9%(P<0.01) in lateral lymphadenectomy group.Sexual function damange(only for male) in total mesorectal excision group accounted for 13.2%,51.9%(P<0.01) in lateral lymphadenectomy group accounted for 51.9%(P<0.01) Local relapse rate in total mesorectal excision group for Dukes B and C cases was 17%,in lateral lymphadenectomy group was 10.3%(P<0.05).The 5-year survival rate of the two groups did not have statistical significant difference(P>0.05).Conclusion: The lateral lymphadenectomy in lower rectal cancer can decrease local relapse,but the postoperative quality of life was affected.