Allemann A, Barras J P, Wagner H E
Klinik für Viszerale und Transplantationschirurgie, Inselspital Bern.
Helv Chir Acta. 1994 Jul;60(5):701-5.
In the controversy whether abdominoperineal resection of sphinctersaving resection is more radical for the treatment of lower rectal cancer, 77 consecutive patients with rectal cancer were retrospectively analysed. All resections were curative. 40 patients underwent a low resection and 37 patients an abdomino-perineal resection. Both groups were comparable with regard to age, sex and especially tumor-stage. The crude 5-year survival-rates were 52.5% in the resection group and 54.1% in the amputation group, respectively. The patients with a carcinoma located within 5-10 cm from the anal verge were of special interest. The crude 5-year survival-rates in these special subgroups were 61.9% for the sphinctersaving procedure and 61.5% for the amputation group, respectively. We conclude that the choice of surgical procedure does not influence the prognosis in rectal cancer, in particular, sphinctersaving resection does not worsen the prognosis. Therefore, whenever technically possible, the sphincter-saving resection should be chosen to cure rectal cancer.
在关于腹会阴切除术与保留括约肌切除术哪种术式治疗低位直肠癌更为彻底的争议中，我们对77例连续的直肠癌患者进行了回顾性分析。所有手术均为根治性手术。40例患者接受了低位切除术，37例患者接受了腹会阴切除术。两组在年龄、性别尤其是肿瘤分期方面具有可比性。切除组和截肢组的5年粗生存率分别为52.5%和54.1%。距肛缘5 - 10厘米处有癌肿的患者尤其值得关注。在这些特殊亚组中，保留括约肌手术的5年粗生存率为61.9%，截肢组为61.5%。我们得出结论，手术方式的选择不会影响直肠癌的预后，特别是保留括约肌切除术不会使预后变差。因此，只要技术上可行，应选择保留括约肌切除术来治疗直肠癌。
