Houry S, Vons C, Huguier M
Service de Chirurgie Digestive, Hôpital Tenon, Paris.
Gastroenterol Clin Biol. 1990;14(1):28-32.
Between 1970 and 1988, 32 patients underwent laparotomy for local recurrence following a curative and restorative resection for carcinoma of the colon and rectum. Histological confirmation was obtained in 30 cases. Of the 28 patients for whom the site of local recurrence could be defined, the previous anastomosis was involved in 25. At laparotomy, 12 patients had disseminated lesions: 5 of these patients had complete resection of lesions which were, however, considered as palliative. Twenty patients had a local recurrence without metastasis. Five of them had unresectable lesions and 15 were amenable to curative resection. After curative resection, the median survival time was 34 months, and 5-year actuarial survival time was 26 percent. After palliative surgery, the median survival time was 5 months, but 1 patient is still alive 12 years after radiationtherapy. These results emphasize the importance of follow-up, given the high salvage rate in patients in whom curative resection can be performed.
1970年至1988年间,32例患者因结肠直肠癌根治性和修复性切除术后局部复发接受了剖腹手术。30例获得了组织学确诊。在28例可明确局部复发部位的患者中,25例累及先前的吻合口。剖腹手术时,12例患者有播散性病变:其中5例患者病变得到了完整切除,但被视为姑息性切除。20例患者有局部复发但无转移。其中5例有无法切除的病变,15例适合根治性切除。根治性切除术后,中位生存时间为34个月,5年精算生存率为26%。姑息性手术后,中位生存时间为5个月,但1例患者放疗后12年仍存活。鉴于可进行根治性切除的患者挽救率较高,这些结果强调了随访的重要性。