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目的 比较全直肠系膜切除（ TME）和传统手术方法对直肠癌术后局部复发及长期生存率的影响。 方法 将 1993年 9月起采用 TME术的直肠癌患者 168例与 1981～ 1992年行传统切除方法的 126例患者进行比较，分析两组的临床病理参数。结果 手术后并发症发生率无差异， TME组 2年复发率为 4. 6％， 明显低于对照组的 20. 6％ (P=0.001)。 2年及 3年生存率 TME组分别为 87.1％和 80.3％，对照组分别为 76.1％ 和 68.7％， TME组生存率高于对照组 (P=0.013)。 TME技术、肿瘤的 Dukes分期、患者的年龄、肿瘤距肛门的距离等因素中，只有 TME是独立的影响生存率的指标， TME、肿瘤的 Dukes分期是独立的影响局部复发的指标。结论 对于距离肛门 12 cm范围内的直肠癌，采用 TME技术能有效地降低局部复发率及提高患者生存率。
Objective To compare the effects of total mesorectal excision (TME) and traditional surgical methods on local recurrence and long-term survival of rectal cancer. METHODS: 168 patients with rectal cancer who underwent TME surgery from September 1993 and 126 patients underwent traditional excision from 1981 to 1992 were compared to analyze the clinicopathological parameters of the two groups. Results There was no difference in postoperative complication rates. The recurrence rate in the TME group at 2 years was 4.6%, which was significantly lower than that of the control group at 20.6% (P=0.001). The 2-year and 3-year survival rates were 87.1% and 80.3% in the TME group, 76.1% and 68.7% in the control group, respectively. The survival rate in the TME group was higher than that in the control group (P=0.013). Among TME technology, tumor Dukes stage, patient's age, tumor distance from the anus, and other factors, only TME is an independent indicator of survival, TME, tumor Dukes stage is an independent indicator of local recurrence. Conclusion For rectal cancer within 12 cm from the anus, the use of TME technology can effectively reduce the local recurrence rate and improve patient survival.