Zhou Xin, Shang Jun-Qing, Zhou Jian-Nong
Division of Colorectal Surgery, Department of General Surgery, Jiangsu Provincial Cancer Hospital, Nanjing 210009, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2009 Jan;12(1):44-7.
To evaluate the efficacy of transsacral local wide resection for mid-lower rectal tumors.
Clinical data of 133 patients undergone transsacral local wide resection for mid-lower rectal tumors between September 1994 and September 2005 were analyzed retrospectively.
No patient died during operation. Fecal fistula occurred in 6(4.5%) patients. Negative resection margin was proved histologically in all the patients. Postoperative diagnosis was adenoma in 28 patients, hyperplastic polyp in 3 patients, carcinoid in 8 patients, gastrointestinal stromal tumor in 1 patient,adenoma with intra-mucosal carcinogenesis in 29 patients and adenocarcinoma invading into submucosa in 64 patients. Median follow-up was 76 months in 64 patients with T(1) adenocarcinoma, whose 5-year cumulative local recurrence and overall survival were 2.0% and 100% respectively. No local recurrence was observed in other patients.
Transsacral local wide resection is simple and safe for mid-lower rectal tumors, which is an appropriate procedure for mid-lower rectal benign tumor and can serve as a sphincter-saving operation for selected T(1) lower rectal carcinoma.
评估经骶骨局部广泛切除治疗中低位直肠肿瘤的疗效。
回顾性分析1994年9月至2005年9月期间133例行经骶骨局部广泛切除治疗中低位直肠肿瘤患者的临床资料。
术中无患者死亡。6例(4.5%)患者发生粪瘘。所有患者组织学检查切缘均为阴性。术后诊断为腺瘤28例,增生性息肉3例,类癌8例,胃肠道间质瘤1例,黏膜内癌变腺瘤29例,浸润黏膜下层腺癌64例。64例T(1)腺癌患者中位随访76个月,其5年局部复发累积率和总生存率分别为2.0%和100%。其他患者未观察到局部复发。
经骶骨局部广泛切除治疗中低位直肠肿瘤简单安全,是中低位直肠良性肿瘤的合适术式,对部分T(1)低位直肠癌可作为保肛手术。