距肛缘≤8 cm的T1期直肠癌患者经肛门局部切除术的预后及影响因素分析

doi:10.11904/j.issn.1002-3070.2018.06.012

摘要/Abstract

摘要： 目的研究距肛缘距离≤8 cm的T₁期直肠癌患者经经肛门局部切除术的预后及其影响因素。方法回顾性分析2010年3月—2014年3月本院180例距肛缘≤8 cm的T₁期直肠癌患者临床资料, 其中90例作为观察组, 另90例接受直肠癌根治术的T1期患者作为对照组, 比较两组患者术后恢复效果, 记录两组术后3年总生存率和无进展生存率, 分析距肛缘≤8 cm的T1期直肠癌患者经肛门局切术后的预后影响因素。结果观察组手术时间、术中出血量、术后肛门首次排气时间、术后住院时间及术后并发症发生率均显著低于对照组, 差异有统计学意义(P＜0.05)。两组总生存期和无进展生存期差异均无统计学意义(χ²=0.896, 0.358;P=0.344, 0.550)。Cox回归分析结果显示年龄、分化程度及切缘性质是影响接受直肠癌局部切除术的距肛缘距离≤8 cm的T₁期直肠癌患者预后的独立危险因素(P＜0.05)。结论经肛门局部切除术治疗距肛缘距离≤8 cm直肠癌T₁期患者可获得与根治术相似的预后收益, 且有助于促进术后早期恢复, 年龄、肿瘤分化程度及切缘性质是影响局切术患者预后的独立影响因素。

关键词: 直肠癌, 局部切除术, 距肛缘距离≤8 cm, 预后

Abstract: Objective The Objective of this was to investipate study the prognostic and influence factors in patients with transanal local resection for stage T₁ rectal cancer with the distance from anal margin ≤8 cm. Methods A fotal of patients with 180 rectal cancer of stage T₁ with the distance from anal margin ≤8 cm from March 2010 to March 2014 were Retrospective analysed, and there were 90 cases received the local resection of rectal cancer as the observation group and 90 patients with the T₁ stage who underwent radical resection of rectal cancer as the control group.The postoperative recovery effects were compared between the abservation and control groups.The rates of 3-year overall survival and progression-free survival were recorded.The prognostic influence factors of rectal cancer patients at the stage T₁ with the distance from the anal margin ≤8 cm after transanal local resection were analyzed. Results The operation time, intraoperative blood loss, postoperative anal exhaust time, postoperative hospitalization stay and postoperative complications were significantly lower in the observation group than those in the control group(P＜0.05).There were no significant difference in overall survival and progression free survival between the two groups(χ²= 0.896, 0.358;P=0.344, 0.550).Logistic multivariate analysis showed that age, degree of differentiation and cutting edge properties were independent risk factors for the prognosis of patients with rectal cancer who were ≤8 cm from the anal margin(P＜0.05). Conclusion Transanal local resection for patients with rectal cancer T₁ stage from distance to anal margin can achieve similar prognostic benefits as radical surgery, and it can promote early recovery after surgery.Age, tumor differentiation and marginal properties are independent factors, which affected the prognosis of the patients undergoing surgery.

Key words: Rectal cancer, Local excision, The distance from the anal margin ≤8 cm, Prognosis

中图分类号:

R735.3

肖洪伟, 陈升, 王艳良, 苏学良. 距肛缘≤8 cm的T₁期直肠癌患者经肛门局部切除术的预后及影响因素分析[J]. 实用肿瘤学杂志, 2018, 32(6): 545-549.

XIAO Hongwei, CHEN Sheng, WANG Yanliang, SU Xueliang. The prognostic and influence factors analysis of transanal local resection for stage T₁ rectal cancer with the distance from anal margin ≤8 cm[J]. PRACTICAL ONCOLOGY JOURNAL, 2018, 32(6): 545-549.

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距肛缘≤8 cm的T₁期直肠癌患者经肛门局部切除术的预后及影响因素分析

The prognostic and influence factors analysis of transanal local resection for stage T₁ rectal cancer with the distance from anal margin ≤8 cm

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