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探讨扩大根治术在低位直肠癌保肛手术中的临床意义。方法:在265例低位直肠癌中选择158例实施保肛手术,对其中62例在扩大根治术同时完成保肛手术。结果:总转移率54.8％。上方淋巴结转移率53.4％,侧方淋巴结转移率17.2％,下方淋巴结转移率0％,转移度9.1％。术后随访结果:扩大保肛组;3年生存率73.1％,局部复发率0％;一般保肛组:3年生存率65.2％,局部复发率5.16％。排便功能:优占80％,可占16.5％,差占3.5％。结论:扩大根治术可有效防止低位直肠癌保肛术后局部复发,术后排便功能良好,不增加手术合并症。
To explore the clinical significance of extended radical resection in anus-preserving surgery for low rectal cancer. Methods: Among 265 cases of low rectal cancer, 158 cases of sphincter preserving surgery were performed, and 62 cases of sphincter preservation surgery were performed at the same time. Results: The overall transfer rate was 54.8%. The upper lymph node metastasis rate was 53.4%, the lateral lymph node metastasis rate was 17.2%, the lower lymph node metastasis rate was 0%, and the metastatic degree was 9.1%. Postoperative follow-up results: expanded sphincter preservation group; 3-year survival rate of 73.1%, local recurrence rate of 0%; general sphincter preservation group: 3-year survival rate of 65.2%, and local recurrence rate of 5.16%. Defecation function: 80% excellent, 16.5%, and 3.5% difference. Conclusion: Extended radical mastectomy can effectively prevent the local recurrence of low rectal cancer after sphincter preserving, and it has good postoperative defecation function without increasing surgical complications.