摘要
目的研究全直肠系膜切除和术前治疗对直肠癌局部复发的影响。方法2000年1月至2004年8月间接受全直肠系膜切除手术的161例直肠癌患者作为研究组;1996年1月至1999年12月间接受直肠癌手术的173例患者作为对照组。收集两组患者的临床病理和随访资料,比较其手术并发症、局部复发情况的差异。结果两组患者手术并发症发生率比较(P>0.05),差异无统计学意义。研究组肿瘤局部复发率为2.5%,低于对照组的8.0%(χ2=5.144;P=0.023)。研究组中57例接受术前治疗,肿瘤局部复发率为1.8%;而没有接受术前治疗患者的肿瘤局部复发率为3.0%(χ2=1.781,P=0.182);差异无统计学意义。将患者性别、年龄、手术方式、全直肠系膜切除与否、接受术前治疗与否、肿瘤大体类型、分化程度、分期、脉管癌栓、辅助化疗等因素作为协变量,以肿瘤局部复发作为因变量行Logistic回归分析。结果显示全直肠系膜切除和脉管癌栓是影响直肠癌局部复发的主要因素。结论全直肠系膜切除和脉管癌栓有无是影响直肠癌局部复发的主要因素。
Objective To investigate the effect of total mesoreetal exeision（TME） and preoperative therapy on local recurrence in rectal cancer. Methods Rectal cancer patients who received TME in School of Ontology, Peking University,from January 2000 to August 2004 were enrolled in the study group. Patients who received surgical resection for rectal cancer from January 1996 to December 1999, before the introduction of TME, were chosen as controls. Postoperative complications and local recurrence were compared. Clinicopatbelogical and follow-up data were analyzed. Results There were 161 patients in the TME group and 173 as controls. The intra-operative blood loss was significant less, hospital stay shorter, and lymph nodes harvested more in TME group than those in the control group, there was no difference in complication rate between the two groups. Local recurrence （LR） rate was 2.5% in TME and 8.0% in the control group, respectively （X^2 = 5. 144; P = 0. 023）. In TME group, the local recurrence rate was 1.8% in the 77 patients with preoperative therapy, and 2. 9% in the other patients without preoperative therapy（ P = 0. 182）. Logistic regression analysis revealed that TME and vessel cancerous embeli were major risk factors for local recurrence of rectal cancer. Conclusion TME and vessel cancerous emboli are major risk factors for local recurrence of rectal cancer.
出处
《中华胃肠外科杂志》
CAS
2006年第3期207-209,共3页
Chinese Journal of Gastrointestinal Surgery
关键词
直肠肿瘤
全直肠系膜切除
手术前放疗
手术前化疗
肿瘤复发
局部
Rectal neoplasms
Total mesorectal excision
Preoperative radiotherapy
Preoperative chemotherapy
Neoplasm recurrence, local
