【摘要】 目的　为使低位直肠癌手术切除范围更合理 ,降低术后局部复发率 ,减少因人工肛门所造成的痛苦。方法　对 14 7例低位直肠癌外科手术进行回顾性分析。行各种方式的保肛手术 79例 ,行Mile′s手术 68例。Duke′s分期 :A期 17例 ,B期 72例 ,C期 5 8例。结果　本组无瘤生存 3年以上 93例占 72 .1% ;五年以上 71例占 63 .4%。术后局部复发 42例占 2 8.9%。其中盆腔内复发 2 7例占 64 .3 % ( 2 7/42 ) ,坐骨直肠窝内复发 5例占 11.9% ( 5 /42 ) ,吻合口复发 4例占 9.5 % ( 4 /42 )。局部复发与肿瘤病理类型及Duke′s分期有关 ,而与手术方式无关。结论　对低位直肠癌肿瘤分化程度高 ,Duke′s分期为B期、C期患者应适当扩大手术切除范围。对于肿瘤下缘距齿状线 3～ 4cm以上的低位直肠癌应尽可能争取行保肛手术并强调适当扩大盆腔内清扫范围是降低低位直肠癌手术后局部复发的关键更多还原

【Abstract】 ? Objective To explore the rational extent resected in operation for low level rectum cancer to decrease the recurrence rate.Methods Of 147 cases of low rectum cancer including 99 cases were reserved anus and 68 cases underwent Mile′s operation. Results The 3 year survival rate was 72.1%(93 cases)and the 5 year survival rate was 63.4%(71 cases).The recurrence rate was 28.9%(42 cases),which was related to the pathological types and Duke′s stage, not to the operation method.Conclusions The low rectum cancer of Duke′s B or Duke′s C,which presents high malignance, should undergo extended radical operation.Those the distance of lower edge to the dentate line is more than 3～4cm should reserve anus as much as possible and the extended radical operation is key to reducing its recurrence rate. 〔更多还原