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目的：减少腹膜返折以下直肠癌传统的Ｍｉｌｅｓ术后盆腔复发，提高５年生存率。方法：将４５例盆腔淋巴结清扫术与５３例Ｍｉｌｅｓ手术的疗效进行比较，对盆腔淋巴结清扫所得的淋巴结分组病检。结果：盆腔淋巴结清扫组死亡２例，出现并发症３８例，５年生存率为６０．０％±３．８５％，局部复发率为６．６７％；Ｍｉｌｅｓ手术组死亡１例，并发性功能障碍３９例，５年生存率为４５．２％±３．０１％，局部复发率为２０．７５％。结论：只要不过多地清除骶前及盆腔侧壁组织，并注意止血，盆腔淋巴结清扫手术的并发症和手术危险性并不明显增加，盆腔清扫组５年生存率高于Ｍｉｌｅｓ组，但无统计学意义（Ｐ＞０．０５），局部复发率明显低于Ｍｉｌｅｓ组，Ｐ＜０．０５有统计学意义。
OBJECTIVE: To reduce pelvic recurrence after the Miles postoperative retroperitoneal rectal cancer and increase the 5-year survival rate. Methods: The efficacy of 45 cases of pelvic lymph node dissection and 53 cases of Miles operation were compared. The lymph nodes from pelvic lymph node dissection were grouped and examined. Results: Two cases died in pelvic lymph node dissection group and 38 cases had complications. The 5-year survival rate was 60.0%±3.85%, and the local recurrence rate was 6.67%. There was one death in Miles’s operation group. In 39 cases, the 5-year survival rate was 45.2% ± 3.01%, and the local recurrence rate was 20.75%. CONCLUSIONS: As long as the anterior and pelvic sidewall tissues are not removed too much, and attention is paid to bleeding, the complications of pelvic lymph node dissection and the surgical risk are not significantly increased. The pelvic dissection group has a higher 5-year survival rate than the Miles group, but no statistics Significance (P>0.05), the local recurrence rate was significantly lower than the Miles group, P <0.05 was statistically significant.