直肠类癌的诊断与治疗

报告近１７年来收治的直肠类癌１５例，发现６０％病例曾被误诊为直肠息肉、内痔或直肠炎等。因症状缺乏特异性，医生行直肠指检时警惕本病对早期发现有重要意义，确诊仍需病理检查。治疗上，文献多据病变大小确定治疗方式。作者根据本组病例治疗的体会，提出应根据病变大小及浸润深度来确定治疗方案，即病变在２ｃｍ以内者行局部切除；如还有肌层浸润时应加作根治术；病变大于２ｃｍ者作根治术。

THE DIAGNOSIS AND TREATMENT OF RECTAL CARCINOID TUMORS

Fifteen patients with rectal carcinoid tumors were treated from 1970 to 1991. fief ore admision, nine patients (60% ) had been misdiagnosed as polyps, hemorrhoids or proctitis. Diagnosis maybe delayed because of failare to recognize their charasteristics and by the negligence of doing digital examination or proctoscopy. Some aspects of the management of these tumors remain controversial. However, present-day treatment programs call for radical cancer resections only for lesions 2 cm in diameteror larger, and local resections for all others. In reviewing this series of cases and other studies, we advocate that both the size of the lesion and the depth of tumor invasion should be taken as the criteria ofsurgical managements. If the tumor is 2 cm in diameter, or smaller than that, local resection can be performed, but whenever the nuscularis propria is invaded, radical resection should be performed. Radicalresection is strongly indicated for tumors larger than 2 cm.