论文部分内容阅读
过去对中段直肠癌大多行腹会阴联合切除术。自有吻合器后(ILS和EEA),大部分中段直肠癌得以安全地一期切除吻合。目前对肿瘤远端切除5 cm的传统概念,持有不同看法。自1978年采用EEA法后,器械吻合已成为大多数中段直肠癌的首选方法。最初2年,总复发率在60～70%,局部复发达80～85%。为此作者指出,必须仔细权衡这种方法的复发率,以保证对生存不致产生明显的影响。 1976.1～1981.1年共手术治疗90例中段直肠癌。包括:(1)可以根治切除的原发性浸润性直肠腺癌,术前经乙状肠镜检查肿瘤位于肛缘以上6～10 cm;(2)手术医师认为大体肿瘤已全部切除者。非浸润性癌、同时有多原发癌或其他潜在的恶性病变,以及复
In the past, most of the rectal cancers were performed with abdominoperineal resection. After the self-made stapler (ILS and EEA), most of the middle segment of rectal cancer can be safely resection and anastomosis. At present, there are different views on the traditional concept of the distal resection of the tumor by 5 cm. Since the EEA method was adopted in 1978, instrumental anastomosis has become the method of choice for most middle rectal cancers. In the first 2 years, the total recurrence rate was 60 to 70%, and local recurrence was 80 to 85%. The authors pointed out that the recurrence rate of this method must be carefully weighed to ensure that it will not have a significant impact on survival. From 1976.1 to 1981.1, a total of 90 cases of mid rectal cancer were treated with surgery. Including: (1) Primary invasive rectal adenocarcinoma that can be radically resected. The preoperative sigmoidoscopy is used to locate the tumor 6 to 10 cm above the anal verge; (2) The surgeon considers that the gross tumor has been completely resected. Non-invasive cancer with multiple primary cancers or other underlying malignant lesions, as well as complex