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目的:探讨早期直肠癌经肛门局部切除术的临床疗效。方法:前瞻性研究,入组时间为1997年1月-2005年5月。118例早期直肠癌患者分为经肛门局部切除术组(A组,58例)及经腹前切除术组(B组,60例)。分析术后直肠功能,并发症,复发,转移以及随访术后1,3,5年生存率。结果:在侵犯粘膜及粘膜下直肠癌中,局部切除组并发症发生率和控便率均低于前切组,两组有统计学意义(P<0.05)。两组复发,转移及生存率比较无统计学意义。在侵犯肌层的直肠癌中,比较均无统计学意义。结论:经肛门局部切除治疗早期直肠癌(T1期)简单易行,并发症少,并有益于提高术后患者的生活质量,T2期患者应谨慎选择。选择合适的患者进行经肛门局部切除术是保证疗效的关键。
Objective: To explore the clinical efficacy of transanal local resection for rectal cancer. Methods: A prospective study was conducted between January 1997 and May 2005. 118 patients with early rectal cancer were divided into transanal local resection group (A group, 58 cases) and pre-abdominal resection group (B group, 60 cases). The postoperative rectal function, complications, recurrence, metastasis, and 1-, 3-, 5-year survival rates after follow-up were analyzed. RESULTS: In the invasion of mucosa and submucosal rectal cancer, the incidence of complications and the rate of constipation in the local resection group were lower than those in the pre-cut group. There was statistical significance between the two groups (P<0.05). There was no statistically significant difference in recurrence, metastasis, and survival between the two groups. There was no statistically significant difference in rectal cancer invading the muscular layer. Conclusion: Transanal local resection for early colorectal cancer (T1 phase) is simple, with few complications, and is beneficial to improve the quality of life of postoperative patients. T2 patients should be carefully selected. Selecting the right patient for transanal local resection is the key to guaranteeing efficacy.