Els M, Gross T, Ackermann C, Tondelli P
Chirurgische Klinik, St. Claraspital Basel.
Helv Chir Acta. 1993 Jun;59(5-6):729-33.
Between 1984 and 1989 240 patients had radical abdominal resection of a rectal carcinoma. Out of 201 patients surviving 12 months or more postoperatively, two groups are surveyed. The first group presents patients undergoing adjunctive radiation therapy (n = 47), the second group did not undergo postoperative radiation therapy (n = 134). Mean follow-up time postoperatively is 39 months. Within the irradiation group, the incidence of ileus was found to be 23% (11/47), in the non-irradiated group 8% (11/134). Subsequent reoperations in order to clear intestinal obstruction were performed on 4% (5/134) of non-irradiated patients and on 21% (10/47) of the irradiated group. Considering the increased risk of postoperative ileus after rectal resection for rectal carcinoma, serious reflection should be given to assessing the appropriateness of adjunctive radiation therapy.
1984年至1989年间,240例患者接受了直肠癌根治性腹部切除术。在术后存活12个月或更长时间的201例患者中,对两组进行了调查。第一组为接受辅助放疗的患者(n = 47),第二组未接受术后放疗(n = 134)。术后平均随访时间为39个月。在放疗组中,肠梗阻的发生率为23%(11/47),在未放疗组中为8%(11/134)。未接受放疗的患者中有4%(5/134)因肠梗阻进行了后续再次手术,而放疗组中有21%(10/47)进行了再次手术。考虑到直肠癌直肠切除术后肠梗阻风险增加,应认真思考评估辅助放疗的合理性。