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[直肠癌根治术中保留肛门功能的原则与结果]

[Principles and results of narrow rectum continence resection in cancer].

作者信息

Stelzner F, Hansen H

出版信息

Langenbecks Arch Chir. 1984;363(1):17-30. doi: 10.1007/BF01255774.

Abstract

The special anatomy of the "Rectum-Grenzlamellen" is the reason for justification to carry out a curative sphincter-preserving resection in carefully selected cases. In a small segment just above the pelvic floor muscles there are not any lymphnodes, when the lateral ligaments are divided and the rectum is thoroughly mobilized from the sacral concavity and stretched. The length of rectum below the tumor measured on fixed pinned-out pathologic specimens was about 2 cm. The local recurrences were 6% of 196 cases. The 5-year survival rate of this low restorative resection at St. Marks Hospital was excellent. These results suggest that a margin about 2 cm below a rectal carcinoma does not affect survival or local recurrence adversely.

摘要

“直肠-边界板层”的特殊解剖结构是在精心挑选的病例中进行保留括约肌根治性切除术的合理依据。在盆底肌肉上方的一小段区域,当切断侧韧带并将直肠从骶骨凹完全游离并拉伸时,没有任何淋巴结。在固定展开的病理标本上测量,肿瘤下方直肠的长度约为2厘米。196例患者的局部复发率为6%。圣马克医院这种低位修复性切除术的5年生存率极佳。这些结果表明,直肠癌下方约2厘米的切缘不会对生存或局部复发产生不利影响。

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