距肛缘5～8cm直肠癌保肛和非保肛术的疗效比较

• 作 者: 江勃年 张次秀 曾福华
• 机 构: 湖南省肿瘤医院腹外科
• 出 处: 中华普通外科杂志
• 发表日期: 1997年05期
• 关键词: 保肛术 直肠癌保肛 直肠肿瘤 高分化腺癌 分化程度 根治术 淋巴结转移 中低位直肠癌 远处转移率 局部复发率

１９８４年１月～１９９０年１２月对１４５例距肛缘５～８ｃｍ的直肠癌病例做了根治性切除。其中保肛组６９例，非保肛组７６例。两组病理各期之间比较无统计学差别（Ｐ＞０．０５），组织学类型除高分化腺癌保肛组明显高于非保肛组外（Ｐ＜０．０５），其余各类型相比无统计学差别（Ｐ＞０．０５）。局部复发率和远处转移率保肛组为１４５％和１４５％，非保肛组为１７１％和１８４％，两组之间无统计学差别（Ｐ＞００５）。５年生存率保肛组７９％，非保肛组６７％，两组有统计学差别（Ｐ＜００５），以上资料提示，距肛缘５～８ｃｍ的直肠癌选择分化程度较高、体积小、浸润较浅和淋巴结转移少的病例行保留肛门的根治术，可以提高病人的生存质量和生存期。

From January 1984 to December 1990, radical resection was performed on 145 cases of rectal cancer located 5-8 cm away from the anal margin. Among them, 69 were in the anal-preserving group and 76 in the non-anal-anal group. There was no statistically significant difference between the two groups of pathological stages (P>0.05). The histological type was significantly higher in the sphincter preservation group than in the non-anal group (P<0.05). There was no statistical difference (P>0.05). The rates of local recurrence and distant metastasis were 145% and 145% in the anal-preservation group, and 171% and 184% in the non-anal group, respectively. There was no significant difference between the two groups (P>0). 05). The 5-year survival rate was 79% in the anal-preserving group and 67% in the non-anal-anal group. There was a statistical difference between the two groups (P<005). The above data suggested that the degree of differentiation of rectal cancer was 5-8cm away from the anal margin. Patients with small size, shallow infiltration, and less lymph node metastasis undergo radical resection of the anus, which can improve the patient’s quality of life and survival.