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目的 探讨直肠癌术后局部复发的相关因素及再手术的价值。方法 对 2 5例直肠癌术后局部复发的临床资料作一回顾性分析。结果 首次手术时DukesB期 10例 ,C期 15例 ;行Miles术 4例 ,Dixon术 16例 ,Hartman术 2例 ,结肠肛门拖出术 3例。粘液腺癌 12例 ,低分化腺癌 8例 ,腺癌 2例 ,绒毛状腺瘤癌变 3例。肿瘤距远切缘 <3cm者 16例 ,>3cm者 9例。再次手术时 ,12例行根治术 ,9例行姑息性手术 ,4例未能切除。根治术组和姑息性手术组中位生存期分别为 30个月和 12个月 ,未能切除组 2 .3个月。再手术 5年生存率 2 1.7%。结论 直肠癌术后局部复发与肿瘤Dckes分期、组织学类型、术式选择、术前术中“无瘤术”实施有密切关系。对直肠癌局部复发仍应积极手术 ,可提高病人的生存期
Objective To investigate the related factors of local recurrence after rectal cancer and the value of reoperation. Methods A retrospective analysis was performed on the clinical data of local recurrence in 25 patients with rectal cancer. Results During the first operation, there were 10 cases of Dukes B stage, 15 cases of C stage, 4 cases of Miles operation, 16 cases of Dixon operation, 2 cases of Hartman operation, and 3 cases of colonic anorectomy. There were 12 cases of mucinous adenocarcinoma, 8 cases of poorly differentiated adenocarcinoma, 2 cases of adenocarcinoma, and 3 cases of villous adenoma. The distance between the tumor and the distal margin was <3cm in 16 cases and 9cm in >3cm. At the time of reoperation, 12 cases underwent radical surgery, 9 cases underwent palliative surgery, and 4 cases failed to be removed. The median survival time was 30 months and 12 months in the radical surgery group and the palliative surgery group, respectively, and the group was not removed for 2.3 months. The 5-year survival rate was 1.7% after reoperation. Conclusion The local recurrence of rectal cancer has a close relationship with the tumor’s Dckes stage, histological type, operation choice, and the preoperative intraoperative “tumorless surgery” implementation. Local recurrence of rectal cancer should be actively operated to improve patient survival