论文部分内容阅读
目的评估经肛门局部切除低位直肠良恶性肿瘤治疗效果和预后。方法回顾性分析上海交通大学医学院附属瑞金医院普外科2003年1月至2006年7月间经肛门局部切除的86例低位直肠肿瘤临床资料。结果86例中,,良性55例,恶性31例。腺癌26例(30.2%),腺瘤39例(45.3%),类癌3例(3.5%),间质瘤1例(1.2%)及其他肿瘤17例(19.8%)。肿瘤距齿状线距离1~12cm。肿瘤直径<3cm68例(79.1%),直径≥3cm18例(21.9%)。腺癌病例中,19例为T1期和7例T2期。在获得随访的69例中,肿瘤直径<3cm57例,有6例复发;肿瘤直径≥3cm12例,有5例复发,两组差异有显著性意义,P<0.01。16例T1期直肠腺癌的中,2例局部复发,7例T2期直肠腺癌的中,4例局部复发,差异有显著性意义,P<0.05。结论经肛门低位直肠肿瘤局切手术具有低并发症和保持良好的术后功能的优点;能应用于治疗良性和经选择的早期较小恶性肿瘤的治疗;也能应用于治疗不能耐受大手术的病例。
Objective To evaluate the treatment effect and prognosis of benign and malignant tumors of the lower rectum after partial anal resection. Methods The clinical data of 86 patients with rectal cancer treated by anus in the Department of General Surgery, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2003 to July 2006 were analyzed retrospectively. Results 86 cases, benign 55 cases, 31 cases of malignant. Adenocarcinoma was found in 26 cases (30.2%), adenoma in 39 cases (45.3%), carcinoid tumors in 3 cases (3.5%), stromal tumors in 1 case (1.2%) and other tumors in 17 cases (19.8%). Tumor from the dentate line distance 1 ~ 12cm. There were 68 cases (79.1%) with tumor diameter <3 cm and 18 cases (21.9%) with diameter ≥3 cm. Of the adenocarcinoma cases, 19 were T1 and 7 T2. Among the 69 patients who were followed up, there were 57 cases with tumor diameter <3cm, 6 cases had recurrence. There were 12 cases with tumor diameter≥3cm and 5 cases had recurrence. There was significant difference between the two groups (P <0.01.16) In 2 cases of local recurrence, 7 cases of T2 rectal adenocarcinoma, 4 cases of local recurrence, the difference was statistically significant, P <0.05. Conclusions Transluminal anastomotic resection of the lower rectal tumor has the advantages of low complication and good postoperative function; it can be used in the treatment of benign and selected early small malignant tumors; and also in the treatment of patients who can not tolerate major surgery Of cases.