Meijer S, de Rooij P D, Derksen E J, Boutkan H, Cuesta M A
Department of Surgery, Free University Hospital, Amsterdam, The Netherlands.
Eur J Surg Oncol. 1992 Jun;18(3):255-7.
Locally recurrent rectal cancer is, in most cases, unresectable and incurable. Palliative treatment is warranted in many cases because of the presence of severe distressing symptoms. In recurrent disease, intraluminal cryotherapy is an option for palliation. Twenty patients with local recurrence after anterior resection were treated palliatively with cryosurgery for their local symptoms. Six patients had previously had a colostomy before they were referred for palliative treatment. Thirteen patients had more than one symptom. Distant metastases were present in ten cases. The beneficial effect of cryosurgery was evident after two to three sessions. In nine patients cryotherapy achieved complete relief of local symptoms. In these patients the symptom free interval varied from 1 to 24 months (median 11 months); five patients died of disease without local symptoms. Three of these nine patients underwent a bowel diversion at a later stage because of complete stenosis. The number of treatment sessions in this group of patients varied from three to 14. The palliative index varied from 37 to 100% (mean 78%). In nine patients cryotherapy of the local recurrence gave no relief at all. Our results show that in almost half of the patients cryosurgery can palliate local complaints resulting from recurrent tumor growth after anterior resection.
在大多数情况下，局部复发性直肠癌无法切除且无法治愈。由于存在严重的痛苦症状，许多病例需要进行姑息治疗。对于复发性疾病，腔内冷冻疗法是一种姑息治疗选择。20例前切除术后局部复发的患者因局部症状接受了冷冻手术姑息治疗。6例患者在转诊接受姑息治疗之前曾行结肠造口术。13例患者有不止一种症状。10例存在远处转移。两到三次治疗后，冷冻手术的有益效果明显。9例患者冷冻疗法使局部症状完全缓解。在这些患者中，无症状间隔时间为1至24个月（中位数11个月）；5例患者死于疾病，但无局部症状。这9例患者中有3例后期因完全狭窄而行肠改道术。该组患者的治疗次数为3至14次。姑息指数为37%至100%（平均78%）。9例患者局部复发的冷冻疗法完全无效。我们的结果表明，在几乎一半的患者中，冷冻手术可以缓解前切除术后肿瘤复发导致的局部症状。
