目的探討直腸癌前切除(Dixon術(shù)式)術(shù)后吻合口復(fù)發(fā)的原因及防治對策。方法回顧性分析我院1985~1996年間所收治的91例直腸癌前切除術(shù)后吻合口復(fù)發(fā)病例的資料。結(jié)果對前切除術(shù)后吻合口復(fù)發(fā)患者,再次行根治性Miles術(shù)式47例,姑息性切除27例,單純探查11例,余6例放棄手術(shù)。其中行根治性Miles術(shù)的患者術(shù)后獲隨訪32例,其1、3、5年生存率分別為93%、77%和45%。結(jié)論盲目擴(kuò)大前切除術(shù)適應(yīng)證,將增加術(shù)后吻合口復(fù)發(fā)率,直腸指檢、纖維結(jié)腸鏡加活檢是診斷吻合口復(fù)發(fā)的主要手段,對吻合口復(fù)發(fā)應(yīng)積極爭取行再次根治性切除。
引用本文: 劉金林,肖谷欣. 直腸癌前切除術(shù)后吻合口復(fù)發(fā)的原因分析(附91例報告). 中國普外基礎(chǔ)與臨床雜志, 2003, 10(2): 111-113. doi: 復(fù)制
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1. | Obrand DI, Gordon PH. Incidence and patterns of recurrence following curative resection for colorectal carcinoma [J]. Dis Colon Rectum, 1997; 40(1)∶15. |
2. | 童仕倫,王竹平. 復(fù)發(fā)性大腸癌的診斷與治療 [J]. 腹部外科, 2000; 13(5)∶269. |
3. | Filipe MI. Value of histochemical reactions for mucosubstances in the diagnosis of certain pathological conditions of the colon and rectum [J]. Gut, 1969; 10(7)∶ 577. |
4. | Phillips RK. Adequate distal margin of resection for adenocarcinoma of the rectum [J]. World J Surg, 1992; 16(3)∶463. |
5. | Greaves P, Filipe MI, Branfoot AC. Transitional mucosa and survival in human colorectal cancer [J]. Cancer, 1980; 46(4)∶764. |
6. | 馮茂輝,楊國梁,王米娜,等. 直腸癌旁移行粘膜p53、p21表達(dá)及其臨床意義 [J]. 中華實驗外科雜志, 1998; 15(1)∶38. |
7. | Shirouzu K, Isomoto H, Kakegawa T. Distal spread of rectal cancer and optimal distal margin of resection for sphincterpreserving surgery [J]. Cancer, 1995; 76(3)∶388. |
8. | 許玉成,陳元勇,莊竟,等. 直腸癌遠(yuǎn)側(cè)腸壁浸潤規(guī)律的探討 [J]. 外科理論與實踐, 1998; 3(3)∶148. |
9. | 董新舒,趙家宏,趙延忠,等. 復(fù)發(fā)大腸癌41例再手術(shù)問題探討 [J]. 實用外科雜志, 1988; 8(12)∶631. |
- 1. Obrand DI, Gordon PH. Incidence and patterns of recurrence following curative resection for colorectal carcinoma [J]. Dis Colon Rectum, 1997; 40(1)∶15.
- 2. 童仕倫,王竹平. 復(fù)發(fā)性大腸癌的診斷與治療 [J]. 腹部外科, 2000; 13(5)∶269.
- 3. Filipe MI. Value of histochemical reactions for mucosubstances in the diagnosis of certain pathological conditions of the colon and rectum [J]. Gut, 1969; 10(7)∶ 577.
- 4. Phillips RK. Adequate distal margin of resection for adenocarcinoma of the rectum [J]. World J Surg, 1992; 16(3)∶463.
- 5. Greaves P, Filipe MI, Branfoot AC. Transitional mucosa and survival in human colorectal cancer [J]. Cancer, 1980; 46(4)∶764.
- 6. 馮茂輝,楊國梁,王米娜,等. 直腸癌旁移行粘膜p53、p21表達(dá)及其臨床意義 [J]. 中華實驗外科雜志, 1998; 15(1)∶38.
- 7. Shirouzu K, Isomoto H, Kakegawa T. Distal spread of rectal cancer and optimal distal margin of resection for sphincterpreserving surgery [J]. Cancer, 1995; 76(3)∶388.
- 8. 許玉成,陳元勇,莊竟,等. 直腸癌遠(yuǎn)側(cè)腸壁浸潤規(guī)律的探討 [J]. 外科理論與實踐, 1998; 3(3)∶148.
- 9. 董新舒,趙家宏,趙延忠,等. 復(fù)發(fā)大腸癌41例再手術(shù)問題探討 [J]. 實用外科雜志, 1988; 8(12)∶631.