CAJ | 학술논문

目的评价经肛门局部切除治疗低位直肠癌的效果.方法回顾性分析我院2003-2006年49例低位直肠癌经肛门行局部切除术患者(局部切除术组)的临床资料,其中T1期37例,T2期12例;以45例行根治术的Ⅰ期直肠癌患者作为对照(根治术组),其中T1期11例,T2期34例.将两组患者的手术并发症发生率、5年复发率、5年生存率进行对比分析.结果局部切除术组并发症发生率为4.1％ (2/49),根治术组为15.6％ (7/45),两组比较差异有统计学意义(x2=4.69,P＜0.05).局部切除术组患者5年生存率为97.9％,根治术组患者为95.6％,两组比较差异无统计学意义(x2=0.439,P＞0.05).局部切除术组中T2期患者术后复发率为33.3％ (4/12),高于根治术组T2期患者术后复发率(5.9％,2/34),两者比较差异有统计学意义(x2=5.89,P＜0.05);低分化癌患者术后均转移复发.结论对于T1期直肠癌,经肛门局部切除是合理选择,而T2期直肠癌及低分化肿瘤不宜单纯采用局部切除术.
목적 평개경항문국부절제치료저위직장암적효과.방법 회고성분석아원2003-2006년49례저위직장암경항문행국부절제술환자(국부절제술조)적림상자료,기중T1기37례,T2기12례;이45례행근치술적Ⅰ기직장암환자작위대조(근치술조),기중T1기11례,T2기34례.장량조환자적수술병발증발생솔、5년복발솔、5년생존솔진행대비분석.결과 국부절제술조병발증발생솔위4.1％ (2/49),근치술조위15.6％ (7/45),량조비교차이유통계학의의(x2=4.69,P＜0.05).국부절제술조환자5년생존솔위97.9％,근치술조환자위95.6％,량조비교차이무통계학의의(x2=0.439,P＞0.05).국부절제술조중T2기환자술후복발솔위33.3％ (4/12),고우근치술조T2기환자술후복발솔(5.9％,2/34),량자비교차이유통계학의의(x2=5.89,P＜0.05);저분화암환자술후균전이복발.결론 대우T1기직장암,경항문국부절제시합리선택,이T2기직장암급저분화종류불의단순채용국부절제술.
Objective To evaluate the therapeutic effect of transanal local excision in the treatment of low rectal cancer.Methods The data of 49 cases of low rectal cancer patients treated by transanal local excision (group A,37 cases of T1 patients and 12 cases of T2 patients) were reviewed retrospectively,and compared with the group of 45 cases treated by radical resection( group B,11 cases of T1 patients and 34 cases of T2 patients).The 5-year survival rates,recurrence rates and postoperative complications between the two groups were compared.Results The incidence of postoperative complications in group A was significantly lower than that in group B(4.1％ vs 15.6％,x2 =4.69,P ＜0.05 ).The 5-year survival rate of group A was 97.9％ and the 5-year survival rate of group B was 95.6％.There was no significantly statistical difference on the 5-year survival rate between the two groups( x2 =0.439,P ＞ 0.05 ).But for the T2 patients,the recurrence rates in group A was 33.3％,which was significantly higher than the T2 patients in group B(5.9％ ) ( x2 =5.89,P ＜0.05 ).All patients with low histopathological grade tumor in group A showed postoperative recurrence and metastasis.Conclusion Transanal local excision with a rigid criteria can get good curative effect in the T1 patients,but not suitable for the T2 patients or patients with low histopathological grade tumor.