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目的 评价经肛门局部切除治疗低位直肠癌的效果。方法 回顾性分析 1991～ 2 0 0 0年间经肛门局部切除治疗 2 4例低位直肠癌的临床资料。结果 (1) 2 4例均为直肠腺癌。 (2 ) 2 4例直肠癌T0 期 2例 ,T1期 8例 ,T2 期 14例。 (3)围手术期病死率为 0。 (4)术后特异性并发症仅有 1例 ,占 4 2 %。 (5 )有 4例局部复发。其中 1例经局部切除治愈 ;另外 3例行经腹会阴联合切除术 ,其中 1例于术后 3 5年因多发转移死亡。 (6 )本组直肠癌病人经肛门局部切除术后 ,随访均超过 2年 ,5年生存率为 93 10 %。结论 低位直肠癌采用经肛门局部切除手术结合放疗的方法可以达到很好的疗效且并发症少 ,但应严格掌握适应证 ,慎重选择病例。
Objective To evaluate the effect of transrectal partial resection on low rectal cancer. Methods The clinical data of 24 cases of rectal cancer treated by anal partial resection from 1991 to 2000 were retrospectively analyzed. Results (1) 24 cases were rectal adenocarcinoma. (2) There were 2 cases of T0 in 24 cases of rectal cancer, 8 cases in T1 and 14 cases in T2. (3) perioperative mortality was 0. (4) Postoperative specific complications were only 1 case, accounting for 42%. (5) There are 4 cases of local recurrence. One case was treated by local excision and the other three cases underwent transabdominal perineal resection. One case died of multiple metastasis in 35 years after operation. (6) This group of patients with rectal cancer after partial anal resection were followed up for more than 2 years, 5-year survival rate of 93 10%. Conclusion Low rectal cancer by transanal local excision combined with radiotherapy can achieve good results and fewer complications, but should be strictly indications, careful selection of cases.