直肠癌根治术后局部复发37例临床分析

目的 探讨直肠癌根治术后局部复发原因及防治。方法回顾性分析1998年6月～2004年7月我院收治37例直肠癌术后局部复发病例资料。结果37例中，会阴部复发8例，吻合口处复发12例，盆腔、腹腔种植复发17例。本组病例均再次行手术治疗，其中根治性切除率54％(20／37)，姑息性切除率46％(17／37)。结论早期诊断、合理治疗，切除足够肠管，彻底清除淋巴结及所在的肠系膜，术中无瘤操作是减少直肠癌根治术后复发的主要措施。对复发病例应根据复发部位、病期早晚采取以手术为主的综合治疗方案。

The Reasons of Locally Recurrence After Redical Resection Operation for Rectal Cancer

Objective To discuss the reason of recurrence a nd prevention after redical resecti on operation for patients with rectal cancer.Method37cases suffering from recurrence o f rectal cancer between June 1998to J uly 2004were analyzed retrospectively.Results Recurrence in perineum and anastomo tic stoma were in 8and 12cases,abdom inal and pelvic cavity transplant recurr ence in 17cases.All of them reoperated,curative surgery rate was 54%(20/37)and palliative operation rate 46%(17/37).Conclusions Early diagnosis,reasonably therap y,resecting reasonable portion of intestine of primary lesion,perfom ing complete lymphadenectomy and eradicating peritoneal exfoliated cancer cells,and no-touch technique at surgery are im portant in preventing rectal cancer recurrence.Integrative therpy sch emes,of which surgical treatment is the major mean s,should be considered according to the site of recurrence and the stage o f cancer of the recurrence cases.