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目的 :比较保肛与非保肛术应用全直肠系膜切除 (TME)加保留自主神经术 (ANP)的局部复发率 (L RR)差异及影响因素。方法 :172例直肠癌分两组 (Dixon组 12 3例与 Miles组 5 0例 ) ,按 Heald及 Havenga法行 TME及 ANP。结果 :1Dixon组与 Miles组的总局部复发率分别为 4.8% (6 / 12 3)与 18.0 (9/ 5 0 ) ,P <0 .0 5 ;Dixon组内从 A期至 D期的 L RR分别为 0 % (0 / 2 5 ) ,2 .9% (1/ 34 )、 7.7% (4 / 2 5 )及 8.3% (1/ 7) ,其百分率趋势检验有显著差异 ,P <0 .0 5。 2 1997年以前Miles组的 L RR为 36 .8% (7/ 19) ,显著高于 1997年以后 Miles组的 6 .5 % (2 / 31) ,P <0 .0 5 ;前者与 Dixon组的 L RR4.8%比有极显著差异 ,P <0 .0 0 1,后者与 Dixon组比无显著差异 ,P >0 .0 5。结论 :TME加 ANP是降低两类直肠癌根治术后L RR重要因素
Objective : To compare the local recurrence rate (L RR) and the influencing factors of total mesorectal excision (TME) plus autonomic preservation (ANP) in anus-preserving and non-salvage preservation. Methods: 172 cases of rectal cancer were divided into two groups (123 in Dixon group and 50 in Miles group). According to Heald and Havenga method, TME and ANP were performed. Results: 1 The total local recurrence rates of Dixon group and Miles group were 4.8% (6/12 3) and 18.0 (9/50) respectively, P<0.05; L RRs from stage A to D in Dixon group. They were 0 % (0 / 25), 2.9% (1/34), 7.7% (4 / 25), and 8.3% (1/7), respectively. Their percentage trend tests showed significant differences, P <0. 0 5. 2 The LRR of the Miles group before 1997 was 36.8% (7/19), which was significantly higher than that of the Miles group after 1997 (2/31), P <0.05; the former and the Dixon group. There was a significant difference in the ratio of L RR of 4.8%, P <0.01, the latter had no significant difference with the Dixon group, P> 0.05. Conclusion : TME plus ANP is an important factor in reducing LRR after radical resection of two types of rectal cancer