Buchmann P, Manzanell C, Metzger U
Klinik für Viszeralchirurgie, Department Chirurgie, Universitätsspital Zürich.
Chirurg. 1990 Jan;61(1):39-42.
Palliative therapy for rectal carcinoma is only indicated in selected patients who do not tolerate radical surgery or with very advanced disease. In a retrospective series the results of transanal electrocoagulation are analyzed. In addition patients or their relatives were questioned about the treatment related increase in quality of life and the wish of recurrent coagulation if needed. The main indication for transanal electrocoagulation was rectal stenosis, blood loss, discharge of mucosa and tumor as well as pain. Anal incontinence only gets better when it is due to discharge. However, transanal exposition bears the risk of worsening the incontinence. The electrocoagulation is favored by all continent patients before colostomy. The main indication for a colostomy was incontinence and fistula. Palliative irradiation was concentrated in patients with pain. In 59 operations upon 40 patients there was one rebleeding and one death due to sepsis resulting in a mortality of 1.7%. We conclude from our results that transanal electrocoagulation is a safe procedure in patients with rectal carcinoma who do not qualify for radical surgery.
直肠癌的姑息治疗仅适用于无法耐受根治性手术或疾病非常晚期的特定患者。对一组回顾性病例分析了经肛门电凝术的结果。此外,还询问了患者或其亲属治疗对生活质量的改善情况以及必要时再次电凝的意愿。经肛门电凝术的主要适应证为直肠狭窄、失血、黏膜及肿瘤排出以及疼痛。仅当肛门失禁由排出物引起时,情况才会改善。然而,经肛门暴露有使失禁加重的风险。所有大便正常的患者在造瘘术前都倾向于采用电凝术。造瘘术的主要适应证为失禁和瘘管。姑息性放疗主要针对有疼痛的患者。对40例患者进行了59次手术,发生1例再次出血,1例因败血症死亡,死亡率为1.7%。我们从结果中得出结论,经肛门电凝术对于不适合根治性手术的直肠癌患者是一种安全的治疗方法。