Rahman G A
Department of Surgery, College of Medicine, King Khalid University/Asir Central Hospital, Abha, Saudi Arabia.
Ann Afr Med. 2010 Jul-Sep;9(3):164-9. doi: 10.4103/1596-3519.68362.
Cancer of the colon and rectum was considered to be rare in Africa three to four decades ago. This is no longer true though it is not as common as in Western Europe and North America. The aim of this study is to determine the incidence of rectal cancer, its pattern of presentation, diagnosis, treatment and outcome of treatment at the University of Ilorin Teaching Hospital (UITH), Ilorin, Nigeria.
This is a prospective study of all the patients with rectal cancer seen at the UITH from January 1998 to December 2002. Clinical and radiologic findings as well as findings at surgery were recorded and evaluated. They were all histologically confirmed. The data were analyzed using SPSS 10.0.
Thirty-six patients with rectal cancer were seen during the period. The male to female ratio was 1:1. Fourteen (38.9%) of the patients were younger than 40 years. Only three (8.3%) patients presented as emergency. Eighteen patients had resectable lesions at presentation. Ten had abdomino-perineal (A-P) resection and eight had anterior resection. Operative mortality was 5.9%. Ten (60%) of the patients who had A-P resection were alive at 5 years and 62.5% of those who had anterior resection were alive at 5 years. None of the patients who had unresectable tumors was alive at 5 years.
Rectal cancer is not rare in Africans. Surgical therapy still remains as the main treatment. When patients present early, outcome is satisfactory. Since most cases in this environment are accessible to digital rectal examination (DRE), the need for this procedure in patients with lower gastrointestinal symptoms cannot be overemphasized.
三、四十年前，非洲的结肠癌和直肠癌被认为较为罕见。尽管如今其发病率不如西欧和北美地区高，但情况已并非如此。本研究旨在确定尼日利亚伊洛林大学教学医院（UITH）直肠癌的发病率、临床表现模式、诊断、治疗及治疗结果。
这是一项对1998年1月至2002年12月期间在UITH就诊的所有直肠癌患者进行的前瞻性研究。记录并评估临床和放射学检查结果以及手术所见。所有病例均经组织学确诊。使用SPSS 10.0软件对数据进行分析。
在此期间共诊治了36例直肠癌患者。男女比例为1:1。14例（38.9%）患者年龄小于40岁。仅3例（8.3%）患者为急诊就诊。18例患者就诊时病变可切除。10例行腹会阴联合切除术（A-P），8例行前切除术。手术死亡率为5.9%。行A-P切除术的患者中，10例（60%）存活5年；行前切除术的患者中，62.5%存活5年。所有病变不可切除的患者均无存活至5年者。
直肠癌在非洲人当中并不罕见。手术治疗仍是主要的治疗方式。患者早期就诊时，治疗效果令人满意。鉴于在这种环境下大多数病例可通过直肠指检（DRE）确诊，对于有下消化道症状的患者，直肠指检的必要性再怎么强调也不为过。
