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叙述了经骶局部切除治疗直肠癌的适应症、手术方法和效果。认为凡隆起型癌、直径在3cm以下,直肠指诊肿瘤基底又可上下左右推动者,即能行局部根治性切除术。若切下的标本病理学检验结果为低分化,或者肿瘤浸润范围超过粘膜下层,应再追加Miles根治术。手术要点是(1)视野显露良好;(2)要明确辩认臀大肌、提肛肌以及直肠壁的层次;(3)距肿瘤边缘1cm以上全层切除肠壁。24例中,又追加Miles根治术者2例(8％),吻合口瘘7例(29.2％),吻合口狭窄(仅容食指通过)4例(16.7％)。另有3例因局部复发又做了腹会阴联合切除术。本组5年生存率为87.1％。
The indications, surgical methods and effects of rectal cancer treatment by rectal resection were described. Think of all type of cancer, diameter below 3cm, rectal examination of the tumor base can be up and down left and right to promote those who can perform a local radical resection. If the specimen specimen pathology test results are poorly differentiated, or the extent of tumor invasion exceeds the submucosa, Miles radical surgery should be added. The main points of operation are (1) the visual field is well exposed; (2) the level of the gluteus maximus, levator ani muscle, and rectal wall must be clearly identified; (3) the intestinal wall is removed from the tumor by more than 1 cm from the edge of the tumor. Among the 24 cases, 2 cases (8%) were additionally treated with Miles radical surgery, 7 cases (29.2%) with anastomotic leakage, and 4 cases (16.7%) with anastomotic stenosis (only with index finger). Another 3 cases underwent abdominal perineal resection because of local recurrence. The 5-year survival rate in this group was 87.1%.