摘要
长期以来,人们总认为只有腹会阴直肠切除术才能根治直肠癌,但对患者来说,这意味着永久性腹部结肠造口,是病人所不愿接受的。近年来随着对排便生理和肠癌病理的进一步了解以及直肠癌手术方式的进展,人们不但要求根治癌肿,还要求良好的生存质量,因而各种保留肛门括约功能的手术已越来越引起重视。但对腹膜返折平面以下。
Twenty-five cases of extraperitoneal rectal cancer (21 cases of carcinoid not included) were treated bylocal excision during 1954-1984. 15 were early lesions and 10 were late lesions in elderly poor risk patientsunsuitable for radioal excision. There were no recurrence in early lesions during 2-29 years follow up; 8cases were followod more then 5 years and 6 were yet less than 5 years. One case had recurrence afterinadequate excision and was re-exeised locally with no recurrence after 3 years. Our case selection for wholethickness local excision were: (1) Protuberant tumors of high differentiation, confined to mucosa orsubmucosa, small size (<3 cm. ), without musoular fixation and located within 6-8 cm. of anal vergo. (2)Aged or poor risk patients with moderately advanced extraperitoneal lesions could be treated by localfulgeration and cauterization to maintain luminal patency, with the addition of adjuvant radiation therapy.Important points in the technique of whole thickness local excision were discussed in detail.
出处
《肿瘤》
CAS
1987年第4期158-160,193,共4页
Tumor
