目的总结直肠癌术后局部复发的形成原因及再治疗方案。方法回顾分析68例直肠癌根治术后局部复发患者临床资料。结果 68例直肠癌根治术后局部复发病例中首次Miles手术后会阴部及骶前腔复发15例;首次Dixon手术后吻合口复发24例,吻合口周围组织复发21例;淋巴结转移癌复发6例,阴道子宫复发2例。复发原因是由于病灶切除不足,周围淋巴结清除不彻底等。复发病例再次手术切除率为67.6%,其中21例达到了临床根治程度。病变切除及根治切除者5a生存率分别为23.9%及35%。结论对直肠癌患者必需按根治原则彻底切除原发灶及其周围组织,并合理清除淋巴结,对复发病例应积极手术治疗,可延长生存期。 Objective To summarize the causes of postoperative local recurrence of rectal cancer and re-treatment regimen. Methods The clinical data of 68 patients with local recurrence after radical resection of rectal cancer were retrospectively analyzed. Results In 68 cases of local recurrence after radical resection of rectal cancer, 15 cases were recurrent perineal and presacral space after the first Miles operation. In the first Dixon operation, 24 cases were anastomotic recurrence, 21 cases were recurrence around the anastomotic junction, 6 cases were recurrence of lymph node metastasis , Vaginal uterine recurrence in 2 cases. Recurrence due to inadequate excision of the lesion, surrounding lymph node dissection is not complete and so on. The recurrence rate of resected cases was 67.6%, of which 21 cases achieved clinical cure. The 5-year survival rates of patients who underwent resection and radical resection were 23.9% and 35% respectively. Conclusion For patients with rectal cancer, radical resection of the primary tumor and its surrounding tissue must be performed according to the principle of radical treatment. Lymph nodes should be properly removed, and active surgery should be performed on the patients with recurrent cancer to prolong their survival.