中下段直肠癌保肛术201例临床分析

报道１９８６年１月～１９９４年１２月间收治直肠癌患者７８３例，其中，中下段直肠癌５５２例（占７０．５％）。该５５２例中施行各类保肛术２０１例（占３６．４％），其中经腹骶切除５例，经耻骨切除５例，Ｄｉｘｏｎ式６７例，拉下式吻合４４例，拖出式吻合６８例及局部切除１２例。术后３年生存率达９０．９％。文中就保肛手术的根治性、术后排便功能的恢复、并发症的产生和处理以及综合治疗的必要性等问题进行了分析讨论。认为保肛术是治疗中下段直肠癌的一种合理术式，其主要适用于Ｄｕｋｅ’ｓＡ和Ｂ１期病例。采取综合治疗则是预防癌肿复发和提高生存率的重要措施。

CLINICAL ANALYSIS OF RESECTION OF RECTAL CANCER WITH PRESERVATION OF SPHINCTER ANI (REPORT OF 201 CASES OF RECTAL CANCER IN MIDDLE AND LOWER PORTION)

Seven hundred and eighty three cases of rectal carcinoma were treated in this hospital Jan. 1986 to Dec. 1994. There were 552 cases(70. 5% )in which the tumor located in the middle and lower portion of the rectum. of this group, 201 cases were treated with the operations of preservation of sphincter ani. The operations included transabdomino-sacral resection (5 cases),transpubic resection(5 cases ), Dixon's operation (67 cases ), perineal pull through anastomosis (44 cases), Welch's operation (68 cases),and local resection (12 cases). The 3-year survival rate was 90. 9 %. We consider that anal sphincter preservation is rational in the treatment of rectal cancer of middle and lower segment,As ofter as the radical resection and maintenance of normal defecation is concerned,it is suitable for rectal carcinomas in Duke' s A and B1 stages. Combined treatment is necessary to prevent the recurrence and increase the survival rate.