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对一部分经选择的直肠癌患者作局部切除的目的是保留肛门括约肌;这一方法的应用近年来有增加的趋势。本文报告52例直肠癌患者接受局部切除的结果并讨论局部切除手术在直肠癌治疗中的地位。 52例均为溃疡型癌。经肛门或经括约肌(Mason氏法)切除包括邻近直肠壁在内的肿瘤。46例手术后随访在5年以上。病例选择取决于手术前的临床检查和组织学检查结果:临床检查中需经直肠指检确定肿瘤的活动度、距肛门的距离、大小、直肠后淋巴结有无转移以明了局部切除是否可行;组织学检查结果应排除低分化癌。手术后应对全部切除标本重复组织学检查,以证实切除的彻底性、排除直肠壁外的浸润并再次确定肿瘤的
The purpose of partial resection of selected patients with rectal cancer is to retain the anal sphincter; the application of this method has increased in recent years. This article reports the results of local resection in 52 patients with rectal cancer and discusses the role of local resection in the treatment of rectal cancer. 52 cases were ulcerative cancers. The tumor including the adjacent rectal wall is resected via the anus or the sphincter (Mason’s method). 46 cases were followed up for more than 5 years after surgery. Case selection depends on preoperative clinical examination and histological examination results: clinical examination requires digital rectal examination to determine the activity of the tumor, distance to the anus, size, whether there is metastasis of the posterior rectal lymph nodes to determine whether the local resection is feasible; The results of the examination should exclude poorly differentiated cancer. Repetitive histological examination of all resected specimens should be performed after surgery to confirm the thoroughness of the resection, exclude infiltration outside the rectal wall, and re-determine the tumor.