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目的 通过对术后复发的直肠癌手术切除与保守治疗的疗效比较 ,探讨合理的治疗方法。方法 对1997年 1月 1日至 2 0 0 1年 12月 31日新加坡中央医院结肠直肠外科学部 6 4 3例行直肠癌根治术病人的相关资料进行统计分析。结果 6 4 3例行直肠癌根治术后有 81例复发 ,其中 31例 (4 8% )为局部复发 ,5 0例 (7 8% )为远处转移。 4 2例再度接受手术治疗 ,其中 2 5例 (5 9 5 % )行局部复发切除术。然而 ,与 39例转移癌辅助治疗相比 ,再次手术的病例并没有显著地提高生存率。结论 与非手术治疗相比 ,根治术后直肠癌局部复发再次手术切除 ,未必能显著地提高病人的生存率。
Objective To compare the effects of surgical resection and conservative treatment of recurrent rectal cancer after surgery to explore a reasonable treatment. Methods A total of 643 patients undergoing radical resection of rectal cancer from January 1, 1997 to December 31, 2001 in the Department of Colorectal Surgery, Singapore General Hospital were analyzed statistically. Results Sixty-three cases had recurrence after radical resection of rectal cancer, of which 31 cases (48%) had local recurrence and 50 cases (78%) had distant metastasis. Forty-two patients underwent surgical resection again, including 25 cases (59 5%) undergoing local resection. However, the reoperation did not significantly improve survival compared with 39 cases of metastatic adjuvant therapy. Conclusion Compared with non-surgical treatment, local recurrence of rectal cancer after radical resection and surgical resection may not be able to significantly improve the survival rate of patients.