【作者】 郭京；

【导师】 王忠裕；

【作者基本信息】 大连医科大学 ， 外科学， 2010， 硕士

【摘要】 目的：比较Dixon+TME术式与Miles+TME术式对低位直肠癌术后并发症、局部复发率及5年生存率的差异,探讨低位直肠癌术式的选择。方法：收集我院1999年1月-2005年1月收治的低位直肠癌(5-7cm)病例资料212例,其中失访29例,有效病例183例,按Dixon+TME术、Miles+TME术分成两组,对其术后并发症、局部复发率及5年生存率进行回顾性分析。结果：行Dixon+TME术127例、Miles+TME术56例,总手术保肛率69.40%。其中Dixon+TME术组2年内局部复发5例,复发率3.94%,5年生存率69.29%；Miles+TME术组2年内局部复发2例,复发率3.57%,5年生存率75.00%。两组病例的术后并发症、2年局部复发率、5年生存率接近,统计学数据显示无显著性差异(p>0.05)。结论：对肿瘤下缘距肛缘5-7cm的低位直肠癌病例,根据患者的年龄、全身情况、肿瘤所在的部位、浸润的程度、恶性程度等全面考虑是否可作保肛手术,对每个患者应进行个体化分析,保肛术式为首选,Miles+TME术应视为最后的选择。更多还原

【Abstract】 Objective:To investigate the difference of complications、local relapses rate and 5-year survival rate between Dixon+TME and Miles+TME, and explore the operation mode of low position rectal cancer.Methods:To collect the clinical data of 183 patients with low position rectal cancer(5-7cm from anus border) from January,1999 to January, 2005.The patients are divided into two groups:group Dixon+TME and group Miles+TME. Retrospective study complications、local relapses rate and 5-year survival rate.Results:group Dixon+TME (n=127),group Miles+TME(n=56),and the saving anus rate is 69.40%.5 patients in group Dixon+TME are local relapses,and the local relapses rate is 3.94%.5 year survival rate is 69.29%. 2 patients in group Miles+TME are local relapses,and the local relapses rate is 3.57%.5 year survival rate is 75.0%.There was no significant difference in complications、2-year local relapses rate and 5-year survival rate between group Dixon+TME and group Miles+TME (p>0.05)Conclusion:For the patients with rectal cancer(5-7cm from anus border),the choice of Dixon+TME should according to age、location of cancer、infiltration degree、malignant degree etc.Every patient should individual analysis,the first choice is saving anus operation,and the Miles+TME should be the last choice.更多还原