Tschmelitsch J, Kronberger P, Prommegger R, Reibenegger G, Glaser K, Bodner E
Second Department of Surgery, University of Innsbruck, Austria.
Eur J Surg Oncol. 1995 Dec;21(6):640-3. doi: 10.1016/s0748-7983(95)95520-8.
The aim of this retrospective study is to compare the outcome of abdominoperineal excision (APE) and anterior resection (AR) for rectal cancer in 136 patients. Local recurrence rates and 5-year survival probabilities were estimated for the AR and APE group. Further comparisons were carried out between hand-sewn and stapled anastomoses after AR, and between patients after AR and APE for tumours 2 to 6 cm from the dentate line. Local recurrence after AR occurred in 14% and after APE in 10% of these cases. Five-year survival probabilities and local recurrence frequencies showed no statistically significant difference (P > 0.05). Local recurrence rates were 13.5% after hand-sewn anastomoses and 15% after the stapled procedure. No statistically significant difference was observed in the 5-year survival and recurrence rate (P > 0.05). Seventy-four of 136 patients had tumours located 2 to 6 cm from the dentata line. Local recurrence occurred in 21% after AR and 5% after APE, showing a statistically significant difference in frequency (P < 0.05). No significant difference was found in cumulative 5-year survival probabilities. APE for advanced low rectal cancer showed a significant reduction in local recurrences compared to AR.
这项回顾性研究的目的是比较136例直肠癌患者行腹会阴联合切除术（APE）和前切除术（AR）的结果。估计了AR组和APE组的局部复发率及5年生存率。对AR术后手工缝合与吻合器吻合情况进行了进一步比较，还比较了距齿状线2至6cm肿瘤的AR和APE患者情况。在这些病例中，AR术后局部复发率为14%，APE术后为10%。5年生存率和局部复发频率无统计学显著差异（P>0.05）。手工缝合吻合术后局部复发率为13.5%，吻合器吻合术后为15%。5年生存率和复发率无统计学显著差异（P>0.05）。136例患者中有74例肿瘤距齿状线2至6cm。AR术后局部复发率为21%，APE术后为5%，频率差异有统计学意义（P<0.05）。累积5年生存率无显著差异。与AR相比，晚期低位直肠癌行APE可显著降低局部复发率。
