髂内动脉栓塞化疗在腹会阴联合切除术中的应用

目的：对髂内动脉栓塞化疗在直肠癌腹会阴联合切除术的应用进行前瞻性研究，并探讨其近、远期效果。方法：113例低位直肠癌病人，随机分为两组。治疗组68例，在腹会阴联合切除术中，应用抗癌药明胶海绵栓塞双侧髂内动脉；对照组45例，行腹会阴联合切除术。观察并比较两组间的手术出血量、手术时间、局部复发率、5年生存率。结果：治疗组与对照组比较，手术时间及切口感染发生率差异无统计学意义（P〉0．05）；治疗组术中出血量、局部复发率明显低于对照组，而5年生存率则明显提高（P〈0．05）。结论：在直肠癌腹会阴联合切除术中，髂内动脉栓塞化疗是一种安全有效的治疗方法，可显著提高病人的近、远期治疗效果。

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OBJECTIVE: To prospectively investigate the efficacy of chemoembolization of bilateral internal iliac arteries in patients underwent Miles operation. METHODS: One hundred and thirteen patients with rectal cancer were randomly classified into 2 groups. The chemoembolization of bilateral internal iliac arteries with anticancer agents and gelatin sponge particles was applied during Miles operation in the treatment group (68 cases), while Miles operation was performed in the control group (45 cases). The amount of intraoperative bleeding, the operation time, the incidence of local recurrence, and the 5 year survival rate were analyzed and compared between the 2 groups. RESULTS: The complications and the operation time had not significantly different in both groups (P > 0. 05); the amount of bleeding and the incidence of local pelvic recurrence were less, and the 5 year survival rate was higher in the treatment group than that in the control group (P <0.05). CONCLUSION: In Miles operation of rectal cancer, the chemoembolization of bilateral internal iliac arteries is a safe and effective therapy, and it can improve the efficacy of rectal cancer both in the short and long run.