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目的探讨局部切除术治疗早期低位直肠癌的疗效。方法对比随机分组的39例局部切除(TAR组)与35例腹会阴联合切除(APR组)的早期低位直肠癌的治疗效果。术后平均随访6.3年。结果无围手术期死亡。TAR组的并发症发生率7.7%,低于APR组(28.6%)(P=0.030)。TAR组局部复发3例(7.7%),APR组2例(5.7%),P=0.786;TAR组远处转移2例(5.1%),APR组1例(2.8%),P=0.859;TAR组5年生存率89.5%,APR组91.3%,P=0.792,差异均无统计学意义。结论对于未累及肌层的早期低位直肠癌,局部切除术可以获得满意的肿瘤根治效果,同时患者能保留肛门括约功能而获得较高的生活质量。
Objective To investigate the curative effect of partial resection for early low rectal cancer. Methods The therapeutic effect of 39 cases of locally advanced resection (TAR group) and 35 cases of early low rectal cancer (APR group) undergoing perineal episiotomy were compared. After an average of 6.3 years follow-up. Results no perioperative deaths. The incidence of complications in the TAR group was 7.7%, lower than that in the APR group (28.6%) (P = 0.030). There were 3 cases (7.7%) of local recurrence in TAR group, 2 cases (5.7%) in APR group, P = 0.786, 2 cases of distant metastasis in TAR group (5.1%) and 1 case (2.8%) in APR group The 5-year survival rate was 89.5%, APR group 91.3%, P = 0.792, the difference was not statistically significant. Conclusion For the early low rectal cancer without muscularis mucosa, the local excision can obtain satisfactory tumor curative effect, meanwhile, the patient can retain the anus contracting function to obtain a higher quality of life.