Hafner G H, Herrera L, Petrelli N J
Department of Surgical Oncology and Endoscopy, Roswell Park Cancer Institute Buffalo, New York.
Ann Surg. 1992 Jan;215(1):63-7. doi: 10.1097/00000658-199201000-00009.
A retrospective analysis was made of the complications from pelvic exenterations performed over the past 30 years for colorectal adenocarcinoma at the Roswell Park Cancer Institute. Seventy-five patients underwent exenteration, 51 for primary disease (PD) and 24 for recurrent disease (RD). Both total and posterior exenterations were included. Twenty of the fifty-one patients (39%) undergoing exenteration for PD developed severe complications, with an operative mortality rate of 6%. The most common complications were injuries to the ureter or bladder, intra-abdominal abscesses, and anastomotic leaks from the urinary diversion. After exenteration for RD, 12 of 24 patients (50%) developed severe complications, with an operative mortality rate of 4%. The most common major complication was an anastomotic leak from the urinary diversion; this occurred in 33% of all patients with RD (8/24). The authors conclude that, although exenteration for colorectal adenocarcinoma may be performed with a low operative mortality rate, patients must be carefully selected because the associated morbidity rate remains high.
对罗斯韦尔帕克癌症研究所过去30年因结直肠腺癌行盆腔脏器清除术的并发症进行了回顾性分析。75例患者接受了脏器清除术，其中51例为原发性疾病（PD），24例为复发性疾病（RD）。全脏器清除术和后脏器清除术均包括在内。51例因PD接受脏器清除术的患者中有20例（39%）发生了严重并发症，手术死亡率为6%。最常见的并发症是输尿管或膀胱损伤、腹腔内脓肿以及尿流改道术吻合口漏。因RD接受脏器清除术后，24例患者中有12例（50%）发生了严重并发症，手术死亡率为4%。最常见的主要并发症是尿流改道术吻合口漏；在所有RD患者中，这一并发症发生率为33%（8/24）。作者得出结论，尽管结直肠腺癌的脏器清除术手术死亡率可能较低，但由于相关发病率仍然较高，因此必须谨慎选择患者。
