中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
2009年
1期
44-47
,共4页
直肠肿瘤%局部切除术,结骶%治疗效果
直腸腫瘤%跼部切除術,結骶%治療效果
직장종류%국부절제술,결저%치료효과
Rectal neoplasms%Local resection,transsacral%Treatment outcome
目的 探讨经骶尾局部扩大切除术在中下段直肠肿瘤治疗中的应用效果.方法 回顾性分析1994年9月至2005年9月间在江苏省肿瘤医院普通外科接受经骶尾局部扩大切除术治疗的133 例中下段直肠肿瘤患者的临床资料.结果 全组无手术死亡者,6 例(4.5%)并发粪瘘.全组患者肿瘤切缘与基底均阴性.术后诊断为腺瘤28 例,增生性息肉3 例.类癌8 例,间质瘤1 例,腺瘤伴黏膜内癌变29 例,黏膜下癌64 例.64 例T1期腺癌患者中位随访期76个月,5年累计局部复发率2.0%,5年总生存率100%.其余患者均无局部复发.结论 经骶尾局部扩大切除术简便、安全,适合中低位直肠良性肿瘤的治疗与低位T1期直肠癌的选择性保肛手术治疗.
目的 探討經骶尾跼部擴大切除術在中下段直腸腫瘤治療中的應用效果.方法 迴顧性分析1994年9月至2005年9月間在江囌省腫瘤醫院普通外科接受經骶尾跼部擴大切除術治療的133 例中下段直腸腫瘤患者的臨床資料.結果 全組無手術死亡者,6 例(4.5%)併髮糞瘺.全組患者腫瘤切緣與基底均陰性.術後診斷為腺瘤28 例,增生性息肉3 例.類癌8 例,間質瘤1 例,腺瘤伴黏膜內癌變29 例,黏膜下癌64 例.64 例T1期腺癌患者中位隨訪期76箇月,5年纍計跼部複髮率2.0%,5年總生存率100%.其餘患者均無跼部複髮.結論 經骶尾跼部擴大切除術簡便、安全,適閤中低位直腸良性腫瘤的治療與低位T1期直腸癌的選擇性保肛手術治療.
목적 탐토경저미국부확대절제술재중하단직장종류치료중적응용효과.방법 회고성분석1994년9월지2005년9월간재강소성종류의원보통외과접수경저미국부확대절제술치료적133 례중하단직장종류환자적림상자료.결과 전조무수술사망자,6 례(4.5%)병발분루.전조환자종류절연여기저균음성.술후진단위선류28 례,증생성식육3 례.유암8 례,간질류1 례,선류반점막내암변29 례,점막하암64 례.64 례T1기선암환자중위수방기76개월,5년루계국부복발솔2.0%,5년총생존솔100%.기여환자균무국부복발.결론 경저미국부확대절제술간편、안전,괄합중저위직장량성종류적치료여저위T1기직장암적선택성보항수술치료.
Objective To evaluate the efficacy of transsacral local wide resection for mid lower rectal tumors. Methods Clinical data of 133 patients undergone transsacral local wide resection for mid-lower rectal tumors between September 1994 and September 2005 were analyzed retrospectively. Results No patient died during operation. Fecal fistula occurred in 6 (4.5%) patients. Negative resection margin was proved histologically in all the patients. Postoperative diagnosis was adenoma in 28 patients, hyperplastic polyp in 3 patients, carcinoid in 8 patients, gastrointestinal stromal tumor in 1 patient, adenoma with intra-mucosal carcinogenosis in 29 patients and adenocareinoma invading into submucosa in 64 patients. Median follow-up was 76 months in 64 patients with T1 adenocarcinoma, whose 5-year cumulative local recurrence and overall survival were 2.0% and 100% respectively. No local recurrence was observed in other patients. Conclusion Transsacral local wide resection is simple and safe for mid-lower rectal tumors, which is an appropriate procedure for mid-lower rectal benign tumor and can serve as a sphincter-saving operation for selected T1 lower rectal carcinoma.
