低位直肠癌保肛手术（Dixon）与Miles手术疗效的比较

发布时间：2018-05-29 17:27

本文选题：低位直肠癌 + Dixon术　；参考：《大连医科大学》2015年硕士论文

【摘要】：目的:比较低位直肠癌保肛手术(Dixon)与Miles手术的术后恢复效果,包括术后并发症、住院天数、局部复发率、远处转移率、术后生存质量及3年生存率的统计学差异,探讨低位直肠癌的合理治疗方式。方法:回顾性选取我院2009年1月到2011年12月行低位直肠癌(距离肛缘7cm以内)手术病人,共计167例。依据采取手术操作的方法不同,分为两组:Dixon组:施行经腹直肠癌切除术的患者共51例。Miles组:经骶尾腹腔低位直肠癌切除、乙状结肠造口术116例。比较两组间在临床病理学因素、术后并发症、住院天数、局部复发率、远处转移率、术后生存质量及3年生存率的不同,判断是否有统计学差异。结果:两组间在临床病理学因素、术后并发症、住院天数、局部复发率、远处转移率上无统计学意义(P0.05)。Dixon组有效随访42例,3年生存率35/42(68.6%),Miles组有效随访103例,3年生存率82/103(70.7%),总的3年存活率在两组之间无统计学差异(P0.05),生存质量采用PAC-QOL评分表,Dixon组(33.94)明显小于Miles组(46.09),两组间存在统计学差异(P0.05),提示Dixon组在生存质量上明显优于Miles组。结论:两组间在术后并发症、住院天数、局部复发率、远处转移率及3年生存率上没有统计学意义,但在生存质量上Dixon组明显优于Miles组,具有统计学意义,提示低位直肠癌患者在保证根治性切除的情况下,应尽可能选择保肛手术(Dixon术)。
[Abstract]:Objective: to compare the postoperative recovery results of low rectal cancer with Miles operation, including postoperative complications, hospitalization days, local recurrence rate, distant metastasis rate, postoperative quality of life and 3-year survival rate. To explore the rational treatment of low rectal cancer. Methods: a total of 167 patients with low rectal cancer (within 7cm from anal margin) were retrospectively selected from January 2009 to December 2011 in our hospital. According to the different methods of operation, they were divided into two groups: one group was treated with transabdominal resection of rectal cancer (51 cases). Miles group (n = 116) underwent transsacrococcygeal low rectal cancer resection and sigmoidostomy (n = 116). The differences of clinicopathological factors, postoperative complications, hospitalization days, local recurrence rate, distant metastasis rate, postoperative quality of life and 3-year survival rate were compared between the two groups. Results: the clinicopathological factors, postoperative complications, hospital stay and local recurrence rate were observed in the two groups. There was no significant difference in distant metastasis rate between the two groups (P 0.05). Dixon group was followed up effectively in 42 cases, and the 3-year survival rate was 35% 42% 68.6% in the Miles group. The 3-year survival rate was 82 / 103% 70.7%. There was no significant difference in the total 3-year survival rate between the two groups (P 0.05). The quality of life (QOL) was assessed with PAC-QOL scale. The quality of life of Dixon group was significantly better than that of Miles group. Conclusion: there was no significant difference in postoperative complications, hospitalization days, local recurrence rate, distant metastasis rate and 3-year survival rate between the two groups, but the quality of life in Dixon group was significantly better than that in Miles group. It suggested that patients with low rectal cancer should choose anus preserving operation as far as possible under the condition of ensuring radical resection.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R735.37

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