Baatrup G, Pfeiffer P, Svolgaard Birgitte, Jensen H A
Department of Surgery, Section of Colorectal Surgery, Haukeland University Hospital, Bergen, Norway.
Int J Colorectal Dis. 2006 Jan;21(1):7-10. doi: 10.1007/s00384-005-0747-0. Epub 2005 Jun 21.
Eighteen patients with primary fixed rectal cancer as judged by digital rectal examination (DRE) were included. They all had radiation therapy with 60 Gy in 30 fractions combined with oral UFT and Isovorin. All patients were evaluated by DRE and magnetic resonance imaging (MRI) before and after treatment. After 5-7 weeks, eight tumors were mobile on DRE. All eight patients had an R0 resection. Of the remaining ten patients with fixed rectal cancer, eight had an R0 resection. One patient had an R1 resection and one patient was not operated. Intraoperative bimanual rectal examination was performed with one finger through the anus and one hand in the rectovaginal/rectovesical fossa before resection was performed. After chemo-radiation DRE correctly predicted the tumor to be advanced or not in 12/17 patients, MRI in 14/17, and bimanual rectal examination in 17/17 patients.
纳入18例经直肠指检（DRE）判断为原发性固定性直肠癌的患者。他们均接受了60Gy分30次的放射治疗，联合口服优福定和亚叶酸钙。所有患者在治疗前后均通过DRE和磁共振成像（MRI）进行评估。5 - 7周后，8例肿瘤在DRE检查时可活动。这8例患者均进行了R0切除。其余10例固定性直肠癌患者中，8例进行了R0切除。1例患者进行了R1切除，1例患者未接受手术。在进行切除术前，通过肛门插入一根手指并在直肠阴道/直肠膀胱陷凹处用一只手进行术中双合诊直肠检查。放化疗后，DRE在17例患者中的12例中正确预测了肿瘤是否进展，MRI在17例中的14例中正确预测，双合诊直肠检查在17例患者中全部正确预测。
