Rullier E, Laurent C, Carles J, Saric J, Michel P, Parneix M
Department of Digestive Surgery, University of Bordeaux, France.
Br J Surg. 1997 Apr;84(4):525-8.
The aim of this retrospective study was to compare the risk of local recurrence between two groups of patients with low rectal cancer treated by either abdominoperineal resection (APR) or anterior resection.
From 1982 to 1992, 106 low rectal cancers (tumour situated 3-8 cm from the anal verge), of Dukes stage B and C were treated by curative surgery, 52 by APR and 54 by anterior resection. Mean follow-up was 60 months after APR and 50 months after anterior resection.
The local recurrence rate of low rectal cancer was 16 of 52 (31 per cent) after APR and 15 of 54 (28 per cent) after anterior resection. The risk of local recurrence in univariate and multivariate analysis was not associated with clinical and histological variables, nor with the type of intervention.
Sphincter-saving resection can be performed for low rectal cancer without an increased risk of local recurrence.
本回顾性研究旨在比较两组低位直肠癌患者经腹会阴联合切除术(APR)或前切除术治疗后局部复发的风险。
1982年至1992年期间,对106例 Dukes B期和C期低位直肠癌(肿瘤距肛缘3 - 8厘米)患者进行了根治性手术,其中52例行APR,54例行前切除术。APR术后平均随访60个月,前切除术后平均随访50个月。
APR术后52例中有16例(31%)出现低位直肠癌局部复发,前切除术后54例中有15例(28%)出现局部复发。单因素和多因素分析中,局部复发风险与临床和组织学变量以及干预类型均无关。
低位直肠癌可行保留括约肌切除术,且不增加局部复发风险。