直肠癌术后局部复发的再治疗

目的　探讨直肠癌术后局部复发的原因及再手术的重要性。方法　回顾性分析 2 9例直肠癌术后局部复发病例 ,结合文献复习并进行讨论。结果　Dixon术后复发 17例 ,Miles术后复发 8例 ,经腹直肠切除结肠拉出术后复发 2例 ,经肛局部切除术后复发 2例 ;再手术中行Dixon术 3例 ,Miles术 14例 ,Hartmann术 5例 ,后盆腔脏器切除术 1例 ,全盆腔脏器切除术 2例 ,局部姑息治疗 4例。结论　保肛手术指征不能过度放宽 ;注重直肠癌围手术期综合治疗 ;对局部复发病例应采取积极的再治疗。

Retreatment for postoperative local recurrence of rectal carcinoma

Objective To explore the reason of postoperative local recurrence of rectal carcinoma and the importance of reoperation. Methods The experience of diagnosis and treatment for 29 cases with postoperative recurrence of rectal carcinoma were reviewed. Results Recurrence occurred in 17 cases with Dixon operation and 8 cases with Miles operation and 2 cases with laparocoloproctectomy. Dixon, Miles and Hartmann operation were performed in 3, 14 and 5 cases with recurrence, respeitively posterion pelvic organs resection in 1 cases, all pelvic organs resection in 2 cases and local conservative therapy in 4 cases. Conclusions The operative indiction of retaining anus can't release excessively. Combined therapy in perioperation period of rectal carcinoma is important. Retherapy for the cases of local recurrence of rectal carcinoma should be emphasized.