Extended resection for locally advanced primary adenocarcinoma of the rectum
Extended resection for locally advanced primary adenocarcinoma of the rectum
复制标题
局部晚期原发性直肠腺癌的扩大切除
DOI：
10.1007/bf02553481
复制
发表时间：
1989
影响因子：
3.9
通讯作者：
D. Ilstrup
中科院分区：
文献类型：
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作者：
B. Orkin;R. Dozois;R. Beart;D. Patterson;L. Gunderson;D. Ilstrup
为了确定盆腔切除术治疗局限性晚期原发性直肠腺癌患者的围手术期死亡率、发病率和长期预后，作者回顾了1956年至1984年间65例手术患者的经验。所有患者在手术中均出现局部侵犯，无远处转移，所有受累器官均行块切除，目的是治愈。手术平均年龄61岁；其中男性15人（23%），女性50人（77%）。手术包括37例（57%）的腹部会阴切除术，20例（31%）的前低位切除术，8例（12%）的Hartmann手术。此外，42名子宫完整的女性中有34名（81%）接受了胆囊切除术，48名卵巢完整的女性中有37名（77%）接受了卵巢切除术，50名女性中有25名（50%）接受了部分阴道切除术。65例患者中有17例（26%）进行了膀胱切除术，2例患者因肿瘤切除了部分小肠。病理检查显示29例（45%）患者淋巴结受累，组织学证实37例（57%）患者邻近器官扩张。无围手术期死亡，平均生存期为5.7年，25例患者（38%）在平均9.3年的随访期后存活。总体5年生存率为52%。40例患者在随访期间死亡，其中26例（65%）的死亡可归因于复发性癌（25例）或新的原发病变（1例）。5年肿瘤复发的累积概率为39%。
To determine the perioperative mortality and morbidity and the long-term prognosis of patients undergoing extended pelvic resections for localized advanced primary adenocarcinoma of the rectum, the authors reviewed their experience with 65 patients operated on between 1956 and 1984. Local invasion without distant metastasis was present in all patients at operation anden blocresection of all involved organs was performed with intent of cure. Average age at operation was 61 years; 15 (23 percent) were men and 50 (77 percent) were women. Operations included abdominoperineal resection in 37 patients (57 percent), low anterior resection in 20 patients (31 percent), and Hartmann procedure in 8 patients (12 percent). Additionally, 34 of 42 women (81 percent) with intact uteri underwenten blochysterectomy, 37 of 48 women (77 percent) with intact ovaries had oophorectomy, and 25 of 50 women (50 percent) had partial vaginal resection. Seventeen of the 65 patients (26 percent) had a cystectomy, and 2 patients had a portion of small intestine resected in continuity with their tumor. Pathologic examination revealed lymph node involvement in 29 patients (45 percent) and histologic confirmation of adjacent organ extension in 37 patients (57 percent). There were no perioperative deaths, the average survival was 5.7 years, and 25 patients (38 percent) were alive after a mean follow-up period of 9.3 years. Overall five-year survival was 52 percent. Forty patients died during the follow-up period, with 26 (65 percent) of the deaths attributable to either recurrent carcinoma (25 patients) or a new primary lesion (1 patient). The cumulative probability of tumor recurrence at five years was 39 percent.
J.Natl.Cancer.Inst.75。
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