Department of Colorectal Surgery, Catharina Hospital, Eindhoven, The Netherlands.
Intensive Care Department, Catharina Hospital, Eindhoven, The Netherlands.
Eur J Surg Oncol. 2014 Jun;40(6):699-705. doi: 10.1016/j.ejso.2014.02.233. Epub 2014 Feb 28.
The purpose of this study is to evaluate the outcome of abdominosacral resections (ASR) in patients with locally advanced or recurrent rectal cancer.
From 1994 until 2012 patients with locally advanced rectal cancer (LARC) and locally recurrent rectal cancer (LRRC) underwent a curative ASR and were enrolled in a database. The postoperative complication rates, predictive factors on oncological outcome and survival rates were registered.
Seventy-two patients with LRRC (mean age 63; 44 male, 28 female) and 14 patients with LARC (mean age 65; 6 male, 8 female) underwent ASR. R0 resection was achieved in 37 patients with LRRC and 11 patients with LARC. Twenty-seven patients underwent an R1 resection (3 in the LARC group). Eight patients had an R2 resection, compared to no patients in the LARC group. In respectively 26 and 1 patients of the LRRC and LARC groups a grade 3 or 4 complication occurred and the 30-days mortality rate was respectively 3% and 7%. The 5-years overall survival was 28% and 24% respectively.
En bloc radical resection remains the primary goal in the treatment of dorsally located (recurrent) rectal cancer. After thorough patient selection, ASR is a safe procedure to perform, shows acceptable morbidity rates and leads to a good oncological outcome.
本研究旨在评估腹会阴联合切除术（ASR）治疗局部晚期或复发性直肠癌患者的疗效。
从 1994 年到 2012 年，患有局部进展期直肠癌（LARC）和局部复发性直肠癌（LRRC）的患者接受了根治性 ASR，并被纳入数据库。记录了术后并发症发生率、肿瘤学结果的预测因素和生存率。
72 例 LRRC 患者（平均年龄 63 岁；44 名男性，28 名女性）和 14 例 LARC 患者（平均年龄 65 岁；6 名男性，8 名女性）接受了 ASR。LRRC 中有 37 例患者达到了 R0 切除，LARC 中有 11 例患者达到了 R0 切除。27 例患者行 R1 切除（LARC 组中有 3 例）。8 例患者行 R2 切除，而 LARC 组中没有患者行 R2 切除。LRRC 和 LARC 组中分别有 26 例和 1 例患者发生 3 级或 4 级并发症，30 天死亡率分别为 3%和 7%。LRRC 和 LARC 组的 5 年总生存率分别为 28%和 24%。
整块根治性切除仍然是治疗背侧（复发性）直肠癌的主要目标。经过充分的患者选择，ASR 是一种安全的手术方法，具有可接受的发病率，并能获得良好的肿瘤学结果。
