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目的 探讨腺瘤性恶变的特点 ,局部切除术手术指征 ,Kraske后入路局部切除术的优缺点。方法 回顾性分析 1995～ 1999年 18例距肛门 5～ 9cm直肠腺瘤性息肉恶变的临床资料及手术治疗效果。结果 经肛门局部切除术 14例 ,2例于术后 8～ 12mo局部复发。经Krashe后入路局部切除术 4例 ,近期随访无局部复发。结论 腺瘤性息肉恶变局部切除术指征为恶变局限于粘膜内的粘膜癌。Kraske后入路局部切除术治疗直肠中下段腺瘤性息肉恶变具有损伤小 ,显露良好 ,操作简便 ,病灶清除彻底等优点 ,值得临床推广运用。
Objective To investigate the characteristics of malignant tumors with adenomas, surgical indications for local resection, and the advantages and disadvantages of posterior local approach to Kraske. Methods A retrospective analysis of 18 cases from 1995 to 1999 from the anus 5 ~ 9cm malignant rectal adenomatous malignant changes in the clinical data and surgical treatment. Results 14 cases of local anal resection, 2 cases of local recurrence after 8 to 12 months. After Krashe local approach resection in 4 cases, no local recurrence of recent follow-up. Conclusion The indication for malignant local resection of adenomatous polyps is mucosal cancer with malignant lesions confined to the mucosa. Kraske posterior approach local resection for the treatment of malignant tumors in the middle and lower rectal adenomatous polyps has the advantages of small damage, good exposure, easy operation, thorough removal of lesions, etc. It is worthy of clinical application.