Zhonghua wai ke za zhi [Chinese journal of surgery] · 2003
[Trans-sacral local resection for rectal cancer].
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Liu Bao-shan, Yan Jin, Zuo Ming, Liu Chao
Аннотация
OBJECTIVES: To evaluate the effect and the indication of local resection for rectal cancer below the peritoneal reflection.
METHODS: One hundred and thirty-four patients with early rectal carcinoma whose masses were >or= 5 cm or <or= 7 cm apart from the anus border, eminence or surface shape, 1 - 3 cm in the diameter, and could be shook up and down or sideways at basal part. Trans-sacral local resection was performed in all patients.
RESULTS: No recurrence appeared in 47 patients with intra-mucosal carcinoma (M-Ca). In 87 patients with submucosal carcinoma (SM-Ca), 3 patients were positive for the cutting end, 8 showed vessel infiltration, and 5 showed low-differentiated adenocarcinoma. These patients had to accept mile's operation, but one patient had local recurrence and 2 patients had liver metastases. Two patients had local recurrence and 8 had metastasis of the liver and other sites. The total 5-year survival rate was 94%.
CONCLUSIONS: Trans-sacral local resection is an optimal operation since the operative range is small and artificial anus is avoided. However, it is only suitable for early rectal carcinoma. When vessel infiltration or low differentiation or positive cutting end are confirmed, radical operation should be added.
METHODS: One hundred and thirty-four patients with early rectal carcinoma whose masses were >or= 5 cm or <or= 7 cm apart from the anus border, eminence or surface shape, 1 - 3 cm in the diameter, and could be shook up and down or sideways at basal part. Trans-sacral local resection was performed in all patients.
RESULTS: No recurrence appeared in 47 patients with intra-mucosal carcinoma (M-Ca). In 87 patients with submucosal carcinoma (SM-Ca), 3 patients were positive for the cutting end, 8 showed vessel infiltration, and 5 showed low-differentiated adenocarcinoma. These patients had to accept mile's operation, but one patient had local recurrence and 2 patients had liver metastases. Two patients had local recurrence and 8 had metastasis of the liver and other sites. The total 5-year survival rate was 94%.
CONCLUSIONS: Trans-sacral local resection is an optimal operation since the operative range is small and artificial anus is avoided. However, it is only suitable for early rectal carcinoma. When vessel infiltration or low differentiation or positive cutting end are confirmed, radical operation should be added.