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在Miles手术出现以前,直肠癌的治疗是经会阴部或骶部行局部切除,由于没有进行淋巴结清扫,治疗效果很差。据Miles报告,局部切除的57例直肠癌中54例术后复发,复发部位为骨盆部的腹膜、乙状结肠系膜和左髂总动脉分义处的淋巴结。因此,Miles于1908年提出腹会阴联合切口直肠肛门切除,并广泛清除淋巴结,取得了良好疗效。作为直肠癌根治的标准术式,Miles手术至今仍被广泛使用。但随着对直肠癌淋巴转移规律的深入研究,发现Miles对直肠癌淋巴转移规律的认识有不足之处。日本学者深入开展直肠淋巴引流的基础研究,并积极开展直肠癌扩大根治术,取得了良好效果,五年生存率
Prior to the appearance of Miles, rectal cancer was treated with a partial resection through the perineum or ankle, and treatment was poor because no lymph node dissection was performed. According to the report of Miles, 54 cases of locally resection of rectal cancer recur in 54 cases. The recurrence site is the peritoneum, sigmoid mesentery, and lymph nodes at the left common iliac artery. Therefore, in 1908, Miles proposed an abdomino-perineal incision and recto-anal resection and extensive clearance of lymph nodes, which achieved good results. As a standard surgical method for radical rectal cancer surgery, Miles is still widely used today. However, with the in-depth study of the law of lymphatic metastasis of rectal cancer, it is found that Miles has a lack of understanding of the law of lymphatic metastasis of rectal cancer. Japanese scholars carried out basic research on lymphatic drainage of the rectum and actively carried out extensive radical resection of rectal cancer, achieving good results. Five-year survival rate