国际外科学杂志
國際外科學雜誌
국제외과학잡지
INTERNATIONAL JOURNAL OF SURGERY
2011年
11期
734-738
,共5页
吴庆华%宗雅萍%冯波%毛志海%胡伟国%李健文%陆爱国%蒋渝%王明亮%郑民华
吳慶華%宗雅萍%馮波%毛誌海%鬍偉國%李健文%陸愛國%蔣渝%王明亮%鄭民華
오경화%종아평%풍파%모지해%호위국%리건문%륙애국%장투%왕명량%정민화
腹腔镜检查%直肠肿瘤%肿瘤复发%局部%再手术
腹腔鏡檢查%直腸腫瘤%腫瘤複髮%跼部%再手術
복강경검사%직장종류%종류복발%국부%재수술
Laparoscopy%Rectal neoplasms%Neoplasms recurrence%Local%Reoperation
目的 探讨腹腔镜的再次手术在直肠癌术后局部复发病例治疗中的安全性及可行性.方法 将上海市微创外科临床医学中心2004年2月-2009年9月期间17例腹腔镜治疗直肠癌局部复发病例按其盆腔内复发类型分为中央型组(n=14)和前壁型组(n=3).比较两组在一般资料、手术相关数据及总体预后方面的差异.结果 两组在术前一般资料比较中差异无统计学意义(P＞0.05).前壁型组手术时间长于中央型组(P=0.028)；但在术中失血量、手术并发症、术后恢复情况及标本R0切除率方面比较差异无统计学意义(P＞0.05).两组总体5年生存率为36％,中位生存期为42个月,组间生存比较差异无统计学意义(x2=1.641,P=0.200).结论 直肠癌术后局部复发再次手术行腹腔镜治疗安全、可行.选择合适的病例、专科医师的操作和提高R0切除率是保证手术短期和长期预后良好的关键因素.
目的 探討腹腔鏡的再次手術在直腸癌術後跼部複髮病例治療中的安全性及可行性.方法 將上海市微創外科臨床醫學中心2004年2月-2009年9月期間17例腹腔鏡治療直腸癌跼部複髮病例按其盆腔內複髮類型分為中央型組(n=14)和前壁型組(n=3).比較兩組在一般資料、手術相關數據及總體預後方麵的差異.結果 兩組在術前一般資料比較中差異無統計學意義(P＞0.05).前壁型組手術時間長于中央型組(P=0.028)；但在術中失血量、手術併髮癥、術後恢複情況及標本R0切除率方麵比較差異無統計學意義(P＞0.05).兩組總體5年生存率為36％,中位生存期為42箇月,組間生存比較差異無統計學意義(x2=1.641,P=0.200).結論 直腸癌術後跼部複髮再次手術行腹腔鏡治療安全、可行.選擇閤適的病例、專科醫師的操作和提高R0切除率是保證手術短期和長期預後良好的關鍵因素.
목적 탐토복강경적재차수술재직장암술후국부복발병례치료중적안전성급가행성.방법 장상해시미창외과림상의학중심2004년2월-2009년9월기간17례복강경치료직장암국부복발병례안기분강내복발류형분위중앙형조(n=14)화전벽형조(n=3).비교량조재일반자료、수술상관수거급총체예후방면적차이.결과 량조재술전일반자료비교중차이무통계학의의(P＞0.05).전벽형조수술시간장우중앙형조(P=0.028)；단재술중실혈량、수술병발증、술후회복정황급표본R0절제솔방면비교차이무통계학의의(P＞0.05).량조총체5년생존솔위36％,중위생존기위42개월,조간생존비교차이무통계학의의(x2=1.641,P=0.200).결론 직장암술후국부복발재차수술행복강경치료안전、가행.선택합괄적병례、전과의사적조작화제고R0절제솔시보증수술단기화장기예후량호적관건인소.
Objective To investigate the safety and feasibility of reoperatively laparoscopic technique in treatment for locally recurrent rectal cancer.Methods The study enrolled 17 patients with locally recurrent rectal cancer between February 2004 and September 2009 from Shanghai Minimally Invasive Surgery Center.The patients were divided into two groups according to their pelvic recurrence types:central recurrence group (n =14) and anterior recurrence group (n =3).Demographic,surgical data and survival outcomes between two groups were compared.Results The outcomes of demographic data between two groups were not different(P＞ 0.05 ).Compared with central recurrence group,anterior recurrence group had longer operating time (P =0.028).However,the differences of operative blood loss,complications,postoperative rehabilitative outcomes and ratio of R0 resction between groups were not significant ( P ＞ 0.05 ).The overall 5- year survival rate of all the patients was 36％.And the median survival time was 42 months without significant difference between two groups (x2 =1.641,P =0.200).Conclusions Reoperatively laparoscopic technique in treatment for locally recurrent rectal cancer is safe and feasible.Selected patients,specialist operation and higer ratio of R0 resection are the key factors conducive to better short-and long-term outcomes.
