Rasmussen K C, Skarbye M, Hartvigsen A B, Bülow S
Kirurgisk gastroenterologisk afdeling, Hvidovre Hospital.
Ugeskr Laeger. 1997 Dec 8;159(50):7495-9.
Among 75 consecutive patients operated upon with anterior resection for rectal adenocarcinoma during a five year period, 29 (39%) developed local cancer recurrence. The total cumulative five-year survival was 49%, but only 17% in those with a local cancer recurrence. The most important risk factors for development of local recurrence were tumour fixation, intraoperative blood transfusion and surgical routine. Local recurrence was seen in 4/23 (17%) after operation performed by a consultant, 1/5 (20%) after a consultant-supervised operation and 24/47 (51%) after operation by a senior registrar (p < 0.02). As a consequence we recommend that operation for rectal cancer should only be performed or supervised by a few specialists in colorectal surgery.
在五年期间接受直肠腺癌前切除术的75例连续患者中,29例(39%)出现局部癌症复发。五年总累积生存率为49%,但局部癌症复发患者的生存率仅为17%。局部复发最重要的危险因素是肿瘤固定、术中输血和手术常规。由顾问医生进行手术后,局部复发率为4/23(17%);在顾问医生监督下手术后,局部复发率为1/5(20%);由高级住院医生进行手术后,局部复发率为24/47(51%)(p<0.02)。因此,我们建议直肠癌手术仅应由少数结直肠外科专家进行或监督。