直肠癌术式探讨

目的 探讨直肠癌手术方式的选择。方法 对我院1984～1993年行手术切除治疗直肠癌860例作一回顾性分析。结果 全组中施行Dixon术510例,Miles术325例,局部切除术25例。Dixon术后局部复发率为11.8％,五年生存率为50.8％,Miles术则分别为11.1％、56.3％。1990年后与1990年前相比,两种术式术后局部复发率均下降,五年生存率显著提高。结论 直肠癌术式选择应严格按肿瘤病理分期、细胞学类型、远切缘距离和肿瘤大小来进行,正确选择术式及术中腹腔热灌注化疗有助于改善病人生活质量,降低术后局部复发率,提高五年生存率。

Discuss the selection of operative manners of rectal cancer

Objective To discuss the selection of operative manners in rectal cancer. Methods In this study, a retrospective analysis was made to investigate the operative manners in 860 cases suffering from rectal cancer in the past ten years( 1984-1993) . Results 860 patients of rectal cancer treated by Dixon's operation was in 510 cases, Mile's operation was in 325 cases, and local rectomy was in 25 cases. Local recurrence rate and five-year survival rates in Dixon's operation was 11.8% and 50.8%, respectively. But those in Mile's operation was 11.1 and 56.3% respectively. As compared with three years ago, the local recurrence rate reduced and the five-year survival rate increased significantly after 1990. Conclution The selection of operation in rectal cancer was strict in pathological grading, cytological type, distance from tumor sections and the size of carcinoma. Correct operation and hyperthermic peritoneal perfusion chemotherapy improve the patient's living, decrease the recurrent rate and increase the five-year survival rates.