全直肠系膜切除术与传统直肠癌根治术治疗直肠癌的对比研究

目的]比较全直肠系膜切除术（TME）与传统直肠癌切除术对于直肠癌根治术的临床疗效，探讨TME的临床意义。方法]回顾性分析86例行TME手术（TME组）和52例行传统直肠癌根治术（传统组）直肠癌患者的临床资料，比较两组手术时间、术中出血量、住院天数、局部复发率及术后并发症情况。结果]TME组手术时间、术中出血量少于传统手术组，TME组的1年局部复发率低于传统手术组，差异有统计学意义（P〈0．05）。TME组患者术后排尿功能障碍和性功能障碍发生率显著低于传统手术组，差异有统计学意义（P〈0．05）。结论]TME直肠癌根治手术临床疗效明显优于传统直肠癌根治术，其可降低局部复发率，减少术后并发症，已成为中低位直肠癌手术治疗的金标准。

Comparative Study on the Effect of Total Mesorectal Excision(TME) and Conventional Surgical Procedure for Treating Rectal Cancer

Objective] To compare the therapeutic effects of total mesorectal excision（TME）and conventional surgical procedure for treating rectal cancer, and to discuss its clinical significance. Methods] Ninetysix cases were treated with TME and 58 patients were treated with conventional surgical procedure for rectal cancer. Clinical data were retrospectively analyzed. Comparison was conducted between the two groups in terms of operative time, hospitalization day, the amount of intraoperative bleeding, local recurrence rate and postoperative complications. Results]No operative death was noticed. The operative time and the amount of intraoperative bleeding in TME group were less than those in conventional group. The postoperative follow up of 2-3 years showed that local recurrence rate in TME group was lower than that in conventional group（ P〈 0.05）. The incidence of urinary function impairment and the rate of sexual dysfunction in TME group were much lower than those in conventional group（ P〈0.05）. Conclusion] The clinical＇efficacy of TME is signifi- cantly better than conventional surgical procedure for the treatment of middle and lower rectal cancer. It can effectively decrease local recurrent rate and the incidence of postoperative complications. These findings recommend TME as gold standard procedure for treating middle and lower rectal cancer.