Istvan G, Lazorthes F, Lemozy J, Chiotasso P, Gamagani R, Bugat R
Service de Chirurgie Digestive, Hôpital Purpan, Toulouse.
Ann Chir. 1997;51(7):703-6.
From 1973 to 1990, 50 patients with a "small cancer" of the rectum were treated locally either by electrocoagulation or by local excision using an electrical scalpel. 20 patients were treated by electrocoagulation. Their 5-year actuarial survival was 78.3% and the local recurrence rate was 16.5%. 4 treated patients by local excision had a lesion which invaded the serosa and should have been amputated as primary procedure. Three of them relapsed. 26 patients were treated by local excision for a lesion confined to the rectal wall. Their 5-year actuarial survival was 94.4% and the local recurrence rate was 4.5%. The difference in survival and recurrence was significant between electrocoagulation and excision of a lesion confined to the rectal wall. These results suggest that excision is preferable to electrocoagulation as it allows prediction of the result by pathological examination of the operative specimen.
1973年至1990年期间，50例直肠“小癌”患者接受了局部治疗，治疗方式为电凝或使用电刀进行局部切除。20例患者接受了电凝治疗。他们的5年精算生存率为78.3%，局部复发率为16.5%。4例接受局部切除治疗的患者有侵犯浆膜的病变，本应作为主要手术进行截肢。其中3例复发。26例患者因病变局限于直肠壁而接受局部切除治疗。他们的5年精算生存率为94.4%，局部复发率为4.5%。电凝与局限于直肠壁病变的切除在生存率和复发率方面存在显著差异。这些结果表明，切除优于电凝，因为它可以通过对手术标本进行病理检查来预测结果。
