Local recurrence following total mesorectal excision for rectal cancer
Local recurrence following total mesorectal excision for rectal cancer
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DOI：
10.1002/bjs.1800830326
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发表时间：
1996-03-01
影响因子：
9.6
通讯作者：
Sjodahl, R
中科院分区：
文献类型：
--
作者：
Arbman, G;Nilsson, E;Sjodahl, R
本文报告了直肠癌手术后的早期结果，比较了全直肠系膜切除术前后的结果。第一阶段（1984-1986年）诊断直肠癌211例，第二阶段（1990-1992年）诊断直肠癌230例。其中，134例患者在第一阶段（组1）前切除术或腹会阴切除术被认为是治愈性的。在第二阶段，128例根治性前切除术和腹会阴切除术由少数熟悉全直肠系膜切除术的外科医生进行（第2组）。两组在分期分布、根治性手术率、术后并发症或术后死亡率方面无差异。研究期结束后1年，第1组有19例患者发生局部复发，第2组有8例患者发生局部复发（P=0.03）。第1组中13例和第2组中8例怀疑局部根治性，其余121例和120例分别有13例和4例局部复发（P=0.03）。精算分析显示，与第1组相比，第2组4年时局部复发率显著降低（P = 0.03），粗生存率增加（P=0.03）。全直肠系膜切除可降低直肠癌术后局部复发率。
Early results after rectal cancer surgery in a defined population were compared before and after the introduction of total mesorectal excision, In the first period (1984-1986) 211 cases of rectal-cancer were diagnosed and in the second (1990-1992) 230. Of these, 134 patients in the first period (group 1) had anterior resection or abdominoperineal excision which was considered curative. In the second period 128 curative anterior resections and abdominoperineal excisions were performed by a limited number of surgeons familiar with total mesorectal excision (group 2). No differences between the groups were found in stage distribution, rate of curative operations, postoperative complications or postoperative mortality, Local recurrence had developed in 19 patients in group 1 and in eight in group 2, 1 year after the end of the study periods (P=0.03). Local radicality was in doubt in 13 patients in group 1 and in eight In group 2, In the remaining 121 and 120 patients, 13 and four local recurrences respectively were present (P=0.03). Actuarial analysis showed a significant reduction in local recurrence rate (P=0.03) and an increase in crude survival (P=0.03) at 4 years In group 2 compared with group 1. Total mesorectal excision reduces the local recurrence rate after excision of rectal cancer.