朱建华 罗伟伦 香港大学玛丽医院结直肠外科部 中国胃肠外科杂志 2000 0 3 4


    关键词：直肠肿瘤；手术；存活率；复发 期刊 zgwcwkzz 0 209-212 结直肠癌专题论著 fur -->


    

【摘要】目的比较全直肠系膜切除(TME)和传统手术方法对直肠癌术后局部复发及长期生存率的影响。方法将1993年9月起采用TME术的直肠癌患者168例与1981～1992年行传统切除方法的126例患者进行比较，分析两组的临床病理参数。结果手术后并发症发生率无差异，TME组2年复发率为4.6%，明显低于对照组的20.6%(P=0.001)。2年及3年生存率TME组分别为87.1%和80.3%，对照组分别为76.1%和68.7%，TME组生存率高于对照组(P=0.013)。TME技术、肿瘤的Dukes分期、患者的年龄、肿瘤距肛门的距离等因素中，只有TME是独立的影响生存率的指标，TME、肿瘤的Dukes分期是独立的影响局部复发的指标。结论对于距离肛门12cm范围内的直肠癌，采用TME技术能有效地降低局部复发率及提高患者生存率。

Total mesorectal excision forrectal cancer

ZHU Jianhua, LUO Weilun.

    Division of Colonrectal Surgery, Marry Hospital, Hongkong， China

【Abstract】 Objective To investigate the effect of totalmesorectal excision(TME) and conventional surgical procedure on local recurrence andlong-term survival. Methods From September 1993, total mesorectal excision was used as astandard procedure for rectal cancer and consecutive patients treated with conventionalsurgical procedure from 1981 to 1992 as control. There were 168 patients in TME group and126 in control group. Clinicopathologic data were collected prospectively and analyzed.Results No significant difference in morbidity was found between the two groups. Localrecurrence rate 2 years after operation was 4.6% in TME group and 21% in control group(P=0.001). Two and 3 year survival of TME group was 87.1% and 80.3% respectively,significantly higher than that of control group, which was 76.1% and 68.7%respectively. Only TME was an independent indicator for survival among such factors as TME, Dukes stages, patients′ age, tumors′ distance from anus. TME and Dukes stageswere independent indicators for local recurrence. Conclusion As for the patients withrectal cancer less than 12cm from anus, TME can reduce local recurrence and improvesurvival.

【 Key words】 Rectal neoplasm； Surgery； Survival;Recurrence

近年来,直肠系膜在治疗直肠癌中的作用愈来愈受到重视 ......