Division of Colorectal Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan.
Asian J Surg. 2011 Jul;34(3):115-20. doi: 10.1016/j.asjsur.2011.08.002. Epub 2011 Nov 18.
The role of pelvic exenteration in locally advanced rectal cancer (LARC) has not been clearly defined. This procedure carries a mortality rate of approximately 10%. The challenges during pelvic surgery are different between men and women. The morbidity in men with LARC who received pelvic exenteration was analyzed.
Medical records of men with LARC undergoing total pelvic exenteration or supralevator pelvic exenteration from January 1991 to December 2007 were retrospectively reviewed.
A total of 23 cases were included in the analysis. Thirteen patients had primary cancer; 10 had recurrent cancer. Microscopically clear surgical margins were obtained in 14 patients (60.9%). Sixteen patients (69.6%) experienced major or minor postoperative complications. The overall in-hospital mortality rate was 8.7%. Ten patients (43.5%) died within 1 year after surgery. All 10 patients with early mortality experienced refractory complications and repeated surgeries. The longest survival of patients with margin involvement was 25 months. The correlation between involved surgical margins and 1-year mortality was statistically significant (p = 0.001).
Resection margins with tumor involvement after pelvic exenteration is associated with poor prognosis and early mortality in men with locally advanced rectal cancer.
盆腔廓清术在局部晚期直肠癌（LARC）中的作用尚未明确。该手术的死亡率约为 10%。男性和女性在盆腔手术中面临的挑战不同。分析接受盆腔廓清术的局部晚期直肠癌男性的发病率。
回顾性分析 1991 年 1 月至 2007 年 12 月期间接受全盆腔廓清术或上盆腔廓清术的局部晚期直肠癌男性患者的病历。
共纳入 23 例患者进行分析。13 例患者有原发性癌症；10 例有复发性癌症。14 例患者（60.9%）获得了显微镜下清晰的手术切缘。16 例患者（69.6%）出现了主要或次要术后并发症。总的院内死亡率为 8.7%。10 例患者（43.5%）在手术后 1 年内死亡。所有 10 例早期死亡的患者均经历了难治性并发症和反复手术。有切缘受累的患者最长生存时间为 25 个月。手术切缘受累与 1 年死亡率之间存在统计学显著相关性（p=0.001）。
盆腔廓清术后肿瘤累及切除边缘与局部晚期直肠癌男性患者的不良预后和早期死亡相关。
