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目的分析和总结16例直肠癌术后局部复发再手术的临床资料。方法该院1998年1月～2004年6月收治直肠癌局部复发后再次手术治疗16例,对患者的第1次手术情况、再次手术探查结果、再手术方法的选择、术后并发症及其预后等资料进行了回顾性分析。结果16例接受再手术的患者中,首次手术与复发后再次手术的平均间隔时间为(28.4±3.6)个月,其中12例完成了根治性肿瘤再次切除,4例施行姑息性手术治疗。5例患者(31.3%)出现了各类术后并发症共计9项,其中泌尿系统的损伤共4例,无住院死亡病例。随访16例患者中死亡9例(43.8%),平均生存期为(27.6±3.2)个月。4例接受姑息性再手术的患者术后生存期为(10.2±4.1)个月,12例接受根治性再手术的病例术后生存期为(30.3±3.8)个月,显著高于复发后接受姑息性手术的患者。结论经过严格的术前检查和选择的直肠癌局部复发病例,进行积极的再手术治疗是一种安全和有效的手段。
Objective To analyze and summarize the clinical data of 16 cases of rectal recurrence after reoperation. Methods The hospital from January 1998 to June 2004 rectal cancer recurrence after reoperation in 16 cases, the patient’s first surgery, re-exploration of surgical findings, and then the choice of surgical methods, postoperative complications and their Prognosis and other data were analyzed retrospectively. Results Among the 16 patients undergoing reoperation, the average interval between the first operation and the second operation after recurrence was (28.4 ± 3.6) months, of whom 12 had radical resection and 4 had palliative surgery. Five patients (31.3%) had all kinds of postoperative complications of a total of nine, including a total of four cases of urinary tract injury, no hospital deaths. Nine of 16 patients (43.8%) were followed up, the average survival time was (27.6 ± 3.2) months. The survival time was (10.2 ± 4.1) months in 4 patients who underwent palliative reoperation. The survival time of the 12 patients who underwent radical reoperation was (30.3 ± 3.8) months, which was significantly higher than that after recurrence Palliative surgery patients. Conclusion After severe preoperative examination and selected cases of local recurrence of rectal cancer, active re-operative treatment is a safe and effective means.