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目的 探讨直肠癌Miles术后局部复发的原因及防治。方法 1986年 1月至 2 0 0 1年 12月共行直肠癌Miles手术 16 8例 ,对其中术后局部复发 2 7例的临床情况进行回顾性分析。结果 局部复发 2 7例中男性 2 0例 ,平均年龄比首次手术组低 5岁 ,DukesC期 19例 ,组织学高度恶性 15例 ,肿瘤距肛门 3～ 6cm17例。复发再手术 11例 ,5年生存率 2 7 2 % (3/ 11)。结论 术后局部复发与年龄、性别、病期、病理类型、肿瘤部位及根治是否彻底密切相关。预防复发宜做好首次手术。对复发病例力争早发现再手术以延长生存期。
Objective To investigate the causes and prevention of local recurrence after Miles operation in rectal cancer. Methods From January 1986 to December 2001 Miles operation of rectal cancer was performed in 16 8 cases. The clinical data of 27 cases with local recurrence were analyzed retrospectively. Results Twenty-seven male patients were locally recurred. The mean age was 5 years younger than the first surgery group, 19 patients were DukesC stage, 15 were histologically malignant, and 17 patients were from 3 to 6 cm anus. Recurrence and reoperation in 11 cases, 5-year survival rate of 272% (3/11). Conclusion The local recurrence after operation is completely and closely related to age, sex, disease stage, pathological type, tumor location and radical treatment. Prevention of recurrence should be done for the first time surgery. Strive to early detection of recurrence and then surgery to prolong survival.