盆腔脏器切除术治疗复发直肠癌

目的：探讨盆腔脏器切除术治疗复发直肠癌的疗效。方法：对1984年至2000年复发直肠癌患49例行盆腔脏器切了作术的临床资料及生存资料进行分析，结果：全组无手术死亡，R0切除率为91．8％，手术并发症发生率为12．2％，本组总的3年生存率为82．4％，5年生存率为48．7％，其中45例获得R0切除患的3年生存率为83．5％，5年生存率为59．5％，17例行全盆腔脏器切除术患的3年生存率为72．7％，5年生存率为45．5％，结论：盆腔脏器切除术是治疗复发直肠癌的有效方法，严格选择病例，确保R0切除，妥善重建泌尿和消化通道及妥善覆盖盆腔，是获得满意疗效，降低术后并发症发生率的关键。

Pelvic exenteration for recurrent rectal cancer

Objective To investigate the experience and clinical outcome of pelvic exenteration for recurrent rectal cancer. Methods Clinicopathological and periodical follow up data of 49 patients after pelvic exenteration for recurrent rectal cancer from 1984 to 2000 were analyzed retrospectively. Results No perioperative death occurred. The R0 resection rate was 91 8%, and the postoperative complication rate was 12 2%. The overall 3 and 5 year survival rates were 82 4 %and 48 7%respectively. The 3 and 5 year survival rates were 83 5%and 59 5%respectively in 45 patients with R0 resection. The 3 and 5 year survival rates were 72 7%and 45 5%in 17 patients with total pelvic exenteration respectively.Conclusions Pelvic exenteration is the optimal treatment for recurrent rectal cancer. Better survival rate and lower postoperative morbidity rate can be achieved only in strictly selected patients, in whom R0 resection of the tumor, careful reconstruction of urinary and digestive tracts as well as pelvic peritonization are performed.