Dong Xing-Shu, Xu Hai-Tao, Yu Zhi-Wei, Liu Ming, Cu Bin-Bin, Zhao Peng, Wang Xi-Shan
Department of Abdominal Surgery, the Third Affiliated Hospital, Harbin Medical University, Heilongjiang Province, China.
World J Gastroenterol. 2003 May;9(5):970-3. doi: 10.3748/wjg.v9.i5.970.
To discuss the rationality of extended radical resection (ERR) and to guide the surgical treatment of rectal cancer.
Total 211 patients who underwent ERR from 1981 to 1987 (follow-up rate of 94.8 %) were selected to study the patterns of lymphatic metastasis and therapeutic effect. The control group was made of 293 patients with rectal cancer who underwent conventional radical resection (CRR) and its follow-up rate was 98.5 %. The lymph node specimens, obtained by the triple-approach lymph node resection during the radical resection of rectal cancer, were studied by conventional pathological method. The extended radical resection, guided by the patterns of lymphatic metastasis, was applied in the clinical practice.
The incidence of lymphatic metastasis in Chinese patients with advanced rectal cancer was 43.6 %, and that of the upper 2nd and 3rd groups and the lateral group was 14.2 %, 10.9 % and 11 % respectively. The 5,10-year-survival rates of the ERR were 68.0 % and 47.0 %, respectively, which were much higher than those of the conventional radical resection (42.9 % and 25.3 %).
The ERR for rectal cancer removes all the lymph nodes, prevents possible metastasis and finally improves the survival rate.
探讨扩大根治术（ERR）的合理性，指导直肠癌的外科治疗。
选取1981年至1987年接受ERR的211例患者（随访率94.8%），研究其淋巴转移模式及治疗效果。对照组为293例行传统根治术（CRR）的直肠癌患者，随访率98.5%。采用常规病理方法研究直肠癌根治术中经三路淋巴结清扫获取的淋巴结标本。以淋巴转移模式为指导，将扩大根治术应用于临床实践。
中国进展期直肠癌患者淋巴转移发生率为43.6%，其中第二、三组上组及侧组分别为14.2%、10.9%和11%。ERR组5年、10年生存率分别为68.0%和47.0%，远高于传统根治术组（42.9%和25.3%）。
直肠癌扩大根治术可清扫所有淋巴结，预防可能的转移，最终提高生存率。
