浸润其他器官及局部复发结、直肠癌的手术治疗

目的：探讨浸润其他器官及局部复发大肠癌手术治疗的效果及手术治疗的要点。方法：回顾性分析本院１９７５年～１９９８年收治的浸润其他器官及局部复发大肠癌的局部浸润情况及合并切除率，直接法统计生存率。结果：①联合切除情况： １１６６例结肠癌中属Ｄｕｋｅｓ Ｄ期者１２３例，占１０．６％，行联合切除者４１例，占全部病例的３．５％，Ｄｕｋｅｓ Ｄ期病例的３３．３％；２ ３５６例直肠癌中属Ｄｕｋｅｓ Ｄ期者３０５例占１２．９％，行联合切除者１１７例，占全部病例的５．０％，Ｄｕｋｅｓ Ｄ期病例的３８．３％。②４１例结肠癌病人合并切除后的５年生存率为５３．８％。③１１７例直肠癌病人合并全盆腔器官切除者２７例，５年生存率为３３．３％（９／２７），９０例联合部分器官切除后病人的５年生存率为４６．７％（４２／９０）。结论：对浸润其他器官及局部复发大肠癌病人，不论初发或复发，只要病人全身条件具备，应积极采用手术治疗的方法，对延长病人的生存期有重要意义。

Extended Surgery for Far-advanced or Locally Recurrent Colorectal Cancer.

Objective: To investigate the results and surgical characteristics of extended resection in patients with far-advanced primary or locally recurrent colorectal cancer. Methods: The clinical data of patients underwent extended resection as the treatment for colorectal cancer involving adjacent tissues or for lo- cal recurrence during the period of 1975 to 1998 were retrospectively analyzed Results: 1 166 cases of co- lon cancer and 2 356 cases of rectal cancer were enrolled in this study. Of which, 3.5%(n=41) of colon can- cer and 5.0%(n=117) of rectal cancer underwent en bloc resection including adhered tissues or organs. Such extended resection provided an overall 5-year survival rate of 53.8%(27/41) in colon cancer group. As far as the rectal cancer is concerned, 27 cases received total pelvic exenteration, and 5-year survival rate approached to 33.3%(9/27), and 90 cases underwent partial pelvic exenteration, with the 5-year survival rate of 46.7%(42/90). Conclusions: Extended resection including total pelvic exenteration might be an acceptable option in selected patients with primary far-advanced or locally recurrent colorectal cancer, and optical results might be obtained via the procedure.