Vojnosanit Pregl. 2016 Oct;73(10):927-33. doi: 10.2298/VSP150430092M.
BACKGROUND/AIM: Rectal cancer is a major health problem throughout the world, despite the great progress in the treatment and control of the disease. The aim of this study was to determine the effect of mesorectal excision type on local recurrence in patients operated on for rectal cancer within a 3- year period.
The clinical retrospective study was conducted at the Clinic for General Surgery at the Clinical Center in Niš, Serbia, and included 225 patients with rectal cancer. Postoperatively, the patients were observed 36 months. Total mesorectal excision (TME) method was used in 129 (57.33%) patients, and partial mesorectal excision (PME) in 96 (42.66%). There were 145 (64.44%) man and 80 (35.55%) women, average age 66.8 years.
In 58 (25.77%) of the patients cancer was localized in the proximal third of the rectum, in 99 (44%) in the medium third, in 68 (30.22%) it was 8 cm of the anocutaneous line. In 167 (74.22%) patients rectal cancer was in T3 stadium. TME was performed in all the patients with cancer in the distal third of the rectum and in 61.61% of the patients with cancer in the medium third of the rectum. PME was performed in all the patients with localized cancer in the proximal third and in 38.38% of the patients with cancer in the medium third of the rectum. Local recurrence occurred in 20 (8.88%) patients, 12 (9.30%) in the TME group and 8 (8.33%) in the PME group, which was not a statistically significant difference. In 75% of the cases, relapse occurred in the patients in T3 stage. Relapse occurred in 55% of the cases in the second year after the surgery. The median survival of all the patients amounted to 35 months. The total mortality of all respondents in a 3-year period amounted to 5.3%.
There were no statistically significant differences in the incidence of local recurrence and survival among patients who underwent TME and those underwent PME. The type of mesorectal excision does not affect the incidence of local recurrence in node-negative disease stages.
背景/目的：尽管直肠癌的治疗和控制取得了巨大进展，但它仍是全球主要的健康问题。本研究的目的是确定在3年期间接受直肠癌手术的患者中，直肠系膜切除类型对局部复发的影响。
该临床回顾性研究在塞尔维亚尼什临床中心的普通外科诊所进行，纳入了225例直肠癌患者。术后对患者进行36个月的观察。129例（57.33%）患者采用全直肠系膜切除术（TME），96例（42.66%）患者采用部分直肠系膜切除术（PME）。男性145例（64.44%），女性80例（35.55%），平均年龄66.8岁。
58例（25.77%）患者的癌症位于直肠近端三分之一处，99例（44%）位于直肠中段三分之一处，68例（30.22%）距肛门皮肤线8 cm以内。167例（74.22%）患者的直肠癌处于T3期。所有直肠远端三分之一癌症患者以及61.61%直肠中段三分之一癌症患者接受了TME。所有直肠近端三分之一局限性癌症患者以及38.38%直肠中段三分之一癌症患者接受了PME。20例（8.88%）患者发生局部复发，TME组12例（9.30%），PME组8例（8.33%），差异无统计学意义。75%的病例中，复发发生在T3期患者中。55%的病例中，复发发生在术后第二年。所有患者的中位生存期为35个月。3年期间所有受访者的总死亡率为5.3%。
接受TME和PME的患者在局部复发率和生存率方面无统计学显著差异。直肠系膜切除类型不影响淋巴结阴性疾病阶段的局部复发率。
