NERVE-SPARING SURGERY WITH LATERAL NODE DISSECTION FOR ADVANCED LOWER RECTAL-CANCER
NERVE-SPARING SURGERY WITH LATERAL NODE DISSECTION FOR ADVANCED LOWER RECTAL-CANCER
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DOI：
10.1016/0959-8049(95)00164-e
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发表时间：
1995-07-01
影响因子：
8.4
通讯作者：
FUJITA, S
中科院分区：
文献类型：
--
作者：
MORIYA, Y;SUGIHARA, K;FUJITA, S
分析了133例低位直肠癌行保留神经的侧方切除术的患者的生存率和功能结果、手术负担和复发模式。84%的患者保留了可接受的泌尿功能。手术时间平均334分钟，平均失血935分钟。全组5年生存率为67%，其中Dukes' A期为88%，Dukes' B期为74%，Dukes' C期为59%。根据阳性淋巴结的数量，5年生存率包括83%的患者有3个淋巴结，34%的患者有4个以上的淋巴结。Dukes' B期局部复发率为2.7%，Dukes' C期局部复发率为13%。目前，保留盆腔神经的侧方清扫术是最有前途的手术，既保证了充分的淋巴结清扫，又保留了泌尿功能。
133 patients who underwent nerve-sparing surgery with lateral dissection for lower rectal cancer were analysed for survival and functional results, operative burdens, and modes of recurrence. In 84% of patients an acceptable urinary function was preserved. Operative time averaged 334 min, and blood loss averaged 935 mi. The 5-year survival rate was 67% in all patients, and 88% for Dukes' A, 74% for Dukes' B and 59% for Dukes' C. According to the number of positive nodes, the 5-year survival rate comprised 83% of patients with up to three nodes, and 34% of those with more than four nodes. Local recurrent rates were 2.7% in patients with Dukes' B and 13% with Dukes' C. At present, pelvic nerve-sparing procedures with lateral dissection is the most promising surgery, guaranteeing both adequate lymphadenectomy and preservation of urinary function.