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本文分析女性腹膜反折下直肠癌后盆术40例疗效,并与同期女性同部位患者麦氏术95例比较,其泌尿系统并发症,后盆术较麦氏术高一倍。三年生存率为60％(麦氏术为55.8％),其中ⅠⅡ期三年生存率各为85.7％(麦氏术为85.19％)及80％(麦氏术为62.5％),均无差异性,只有Ⅲ期患者三年生存率为63.6％(麦氏为29.41％);Ⅳ_1期为25％(麦氏为0),有所优越。Ⅲ期标准指有淋巴结转移,术前常难确定,结合病理分析,恶性度大(腺癌ⅢⅣ级和粘液癌)约2/3属ⅢⅣ期,故提出妇女腹膜反折以下直肠癌,临床明显与阴道后壁粘连者,或病理高度恶性,肿瘤较大累及直肠前壁,宜行后盆腔脏器切除术。
This article analyzes the efficacy of 40 cases of retroperitoneal resection of rectal cancer in women with peritoneal reflex, and compares with 95 cases of same site female patients underwent Maitreya surgery. The urinary complications and posterior basin surgery are twice as high as those of Maitreya. The three-year survival rate was 60% (55.8% for McCall’s surgery), and the three-year survival rate for phase III was 85.7% (85.19% for Maitreaus) and 80% (62.5% for Maitreya surgery). There was no difference. For patients with stage III disease, only three-year survival rate was 63.6% (Malco’s 29.41%); IV_1 period was 25% (Mc’s was 0), which was superior. Phase III criteria refers to lymph node metastasis, which is often difficult to determine before surgery. Combined with pathological analysis, the degree of malignancy (adenocarcinoma grade III IV and mucinous carcinoma) is about 2/3 of the stage III III. Therefore, it is proposed that women with peritoneal retrograde resection of rectal cancer are clinically obvious. The adhesion to the posterior wall of the vagina, or the pathology is highly malignant. The large tumor involving the anterior rectal wall should be followed by posterior pelvic organ resection.