【摘要】 目的:通过大样本直肠癌全系膜切除术(TME)与传统手术的临床效果比较,探讨TME的应用价值。方法:同期入院手术的Dukes A、B、C期中低位直肠癌患者分为TME组(2394例)和非TME组(2185例),比较2组患者术后的复发率,存活率,吻合口瘘、性功能、泌尿功能、肛门功能障碍发生率,直肠系膜内淋巴结清除情况,判断TME的效果。结果:TME组在手术后复发率、3年及5年存活率、性功能及泌尿功能障碍方面明显优于非TME组,而在吻合口瘘、肛门功能障碍方面,TME组略高于非TME组(P>0.05)。在直肠系膜内的淋巴结清除方面,TME组检出的淋巴结阳性率为20%,非TME组直肠系膜未切除或切除不完整,且肠系膜内淋巴结未清除或清除不彻底。结论:TME能够降低直肠癌术后复发率、死亡率,与传统直肠癌手术比较,能够减少某些并发症。TME手术治疗直肠癌具有较大的应用前景。更多还原

【Abstract】 Objective:To compare the effect of total mesorectal excision(TME) with the traditional operation pattern.And to explore the application value of TME.Methods:The clinical data of 2 394 patients with rectal carcinoma recepted TME(TME group) was analysed retrospectively.And 2185 patients with rectal carcinoma underwent traditional operation(non-TME group) were assigned as control.The rate of relapse,survival,anastomatic leakage,sexual disfounction,urinary disfounction,anus disfounction and lymph node cleaning of mesentery of rectum were compared between the two groups.Results:The results of TME Group,such as reducing the relapse rate after surgery,3-year and 5-year survival rate,decreasing sexual disfounction and urinary disfunction were much better than those of non-TME group.As to the anastomotic fistula and anus dysfunction rate,TME group was slightly higher than the non-TME group,but there was no statistical significance.The lymph nodes positive detected rate of TME group was 20%,while the removal of mesorectal excision of non-TME group didn’t do the mesenteric lymph nodes cleaning or cleaned thorough enough.Conclusion:TME can reduce the rate of rectal cancer relapse,mortality and some of the complications of rectal cancer surgery.TME is prospective.更多还原