Rectal excision and colonic pouch-anal anastomosis for rectal cancer - Oncologic results at five years
Rectal excision and colonic pouch-anal anastomosis for rectal cancer - Oncologic results at five years
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DOI：
10.1007/bf02234211
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发表时间：
1999-10-01
影响因子：
3.9
通讯作者：
Parc, R
中科院分区：
文献类型：
--
作者：
Berger, A;Tiret, E;Parc, R
目的：保留肛门括约肌现已被认为是直肠癌手术治疗的主要目标。完全直肠切除后使用结肠 J 型储袋肛门吻合术是一种可以在不损害本体论原则的情况下保持节制的方法。本研究旨在评估直肠切除术后结肠 J 型储袋肛门吻合术的癌症结果，特别是局部复发率。方法：自1984年至1990年，对167例中低位直肠癌患者进行了全直肠切除及结肠储袋肛吻合术。这项研究对总共 154 名患者进行了至少 5 个梨的随访，并评估了局部复发的频率。结果：65 名患者在监测期间死亡，五年生存率为 68.8%。 20 名患者（13%）平均在术后 31 个月出现局部复发。 11 例（7%）局部复发与转移性疾病无关，其中 6 例患者接受了进一步的根治性手术。结论：这些结果证实，直肠完全切除后结肠吻合术是直肠癌手术治疗的一种有价值的选择，并且孤立性局部复发率低于 7%，其中一半接受了根治性手术切除。
PURPOSE: Preservation of the anal sphincter is now accepted as a primary aim in surgical treatment of rectal cancer. The use of colonic J-pouch-anal anastomosis after complete rectal excision is one method that permits retention of continence without compromising ontologic principles. This study aimed to assess carcinologic results of rectal excision followed by colonic J-pouch anal anastomosis, with particular reference to rate of locoregional recurrence. METHOD: From 1984 to 1990 complete rectal excision and colonic pouch-anal anastomosis were performed in 167 patients for cancer of the middle or low rectum. A total of 154 patients were followed for this study for a minimum of five pears, with evaluation of the frequency of locoregional recurrence. RESULTS: Sixty-five patients died during the period of surveillance, giving a five-year survival rate of 68.8 percent. Twenty patients (13 percent) presented with locoregional recurrence at an average of 31 months after surgery. In 11 cases (7 percent) the local recurrence was not associated with metastatic disease, and six of these patients underwent further curative surgery. CONCLUSIONS: These results confirm that coloanal anastomosis after complete rectal excision is a valuable option in the surgical treatment of rectal cancer and is accompanied by a frequency of isolated locoregional recurrence of less than 7 percent, of which half underwent surgical resection with curative intent.