108例T_(is~1)N_0M_0期中低位直肠癌经肛门局部切除的临床评价

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[目的]探讨Tis~1N0M0期中低位直肠癌经肛门局部切除的合理性。[方法]回顾性分析经肛门局部切除治疗的108例Tis~1N0M0期中低位直肠癌患者的资料。其中TisN0M063例,T1N0M045例。8例T1期患者接受了术后辅助放疗。[结果]所有患者术后恢复顺利,中位住院时间5d(3~8d)。无吻合口漏、直肠狭窄、肛瘘及其他手术并发症。术后肛门括约肌功能良好。5年总生存率为99.07%,Tis、T1期5年生存率分别为100%和97.78%。5年总复发率为1.85%,Tis、T1期5年复发率分别为0、4.44%。[结论]对Tis~1N0M0期中低位直肠癌患者,经肛门局部切除术既保证了生存率,又兼顾了患者的生存质量,为一种较为理想的术式选择。 [Objective] To investigate the rationality of transanal resection of middle and low rectal cancer in Tis ~ 1N0M0 stage. [Methods] A retrospective analysis of 108 cases of Tis ~ 1N0M0 low and middle rectal cancer patients treated by partial anus resection. Including TisN0M063 cases, T1N0M045 cases. 8 cases of T1 patients received postoperative adjuvant radiotherapy. [Results] All patients recovered smoothly after operation, and the median length of stay was 5 days (3-8 days). No anastomotic leakage, rectal stenosis, anal fistula and other surgical complications. Anal sphincter function well. The 5-year overall survival rate was 99.07%. The 5-year survival rates of Tis and T1 were 100% and 97.78% respectively. The 5-year total recurrence rate was 1.85%. The 5-year recurrence rates of Tis and T1 were 0 and 4.44% respectively. [Conclusion] For patients with low and middle rectal cancer of Tis ~ 1N0M0 stage, transrectal resection not only guarantees the survival rate but also takes into account the quality of life of patients, which is an ideal surgical choice.
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