切换至 "中华医学电子期刊资源库"

中华结直肠疾病电子杂志 ›› 2018, Vol. 07 ›› Issue (03) : 281 -284. doi: 10.3877/cma.j.issn.2095-3224.2018.03.017

所属专题: 文献

综述

早期直肠癌的局部切除治疗
聂攀1, 荆鹏飞1, 王存1,()   
  1. 1. 610041 成都,四川大学华西医院胃肠外科中心
  • 收稿日期:2017-09-22 出版日期:2018-06-25
  • 通信作者: 王存

Local excision in early rectal cancer

Pan Nie1, Pengfei Jing1, Cun Wang1,()   

  1. 1. Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
  • Received:2017-09-22 Published:2018-06-25
  • Corresponding author: Cun Wang
  • About author:
    Corresponding author: Wang Cun, Email:
引用本文:

聂攀, 荆鹏飞, 王存. 早期直肠癌的局部切除治疗[J]. 中华结直肠疾病电子杂志, 2018, 07(03): 281-284.

Pan Nie, Pengfei Jing, Cun Wang. Local excision in early rectal cancer[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2018, 07(03): 281-284.

直肠癌是最常见的恶性肿瘤之一,目前外科手术方式包括经腹根治术及局部切除术等方式。随着近年早期直肠癌诊断率逐渐提高,局部切除术也逐渐增加。研究表明,对于严格筛选的早期直肠癌病人,局部切除术较经腹根治手术术后排便及性功能障碍发生率低,同时能获得与根治性手术相似的治疗效果。但由于局部切除术未清扫区域淋巴结,存在较高的局部复发率,需要术前对肿瘤局部浸润及淋巴结状态的精确评估,同时进行良好的术后随访和监测。

Rectal cancer is one of the most common malignant tumors. The surgical methods include radical resection and local excision. With rectal cancer early diagnosis rate increase gradually, local resection has been gradually increased. Research has shown that the incidence rate of defecation dysfunction and sexual dysfunction in local excision rectal cancer patients with strict screened was lower than that of radical resection. However, local excision didn′t clear local lymph nodes, there is a higher rate of local recurrence, which requires accurate assessment of the local infiltration and lymph node status before surgery, and good postoperative follow-up and monitoring.

[1]
Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015 [J]. CA Cancer J Clin, 2016, 66(2): 115-132.
[2]
You YN, Baxter NN, Stewart A, et al. Is the increasing rate of local excision for stage I rectal cancer in the United States justified?: a nationwide cohort study from the National Cancer Database [J]. Ann Surg, 2007, 245(5): 726-733.
[3]
Juul T, Ahlberg M, Biondo S, et al. Low anterior resection syndrome and quality of life: an international multicenter study [J]. Dis Colon Rectum, 2014, 57(5): 585-591.
[4]
Platz J, Cataldo P. Functional outcomes following transanal rectal surgery [J]. Seminars in Colon and Rectal Surgery, 2015, 26(1): 41-44.
[5]
Rutten HJT, den Dulk M, Lemmens VEPP, et al. Controversies of total mesorectal excision for rectal cancer in elderly patients [J]. The Lancet Oncology, 2008, 9(5): 494-501.
[6]
De Graaf EJ, Doornebosch PG, Tollenaar RA, et al. Transanal endoscopic microsurgery versus total mesorectal excision of T1 rectal adenocarcinomas with curative intention [J]. Eur J Surg Oncol, 2009, 35(12): 1280-1285.
[7]
Ptok H, Marusch F, Meyer F, et al. Oncological outcome of local vs radical resection of low-risk pT1 rectal cancer [J]. Archives of Surgery, 2007, 142(7): 649.
[8]
Willett CG, Compton CC, Shellito PC, et al. Selection factors for local excision or abdominoperineal resection of early stage rectal cancer [J]. Cancer, 1994, 73(11): 2716-2720.
[9]
Geva R, Blachar A, Tulchinsky H. The Optimal Staging of Rectal Cancer [J]. Current Colorectal Cancer Reports, 2013, 9(1): 24-30.
[10]
Puli SR, Bechtold ML, Reddy JB, et al. How good is endoscopic ultrasound in differentiating various T stages of rectal cancer? Meta-analysis and systematic review [J]. Ann Surg Oncol, 2009, 16(2): 254-265.
[11]
Bipat S, Glas AS, Slors FJ, et al. Rectal cancer: local staging and assessment of lymph node involvement with endoluminal US, CT, and MR imaging--a meta-analysis [J]. Radiology, 2004, 232(3): 773-783.
[12]
Klessen C, Rogalla P, Taupitz M. Local staging of rectal cancer: the current role of MRI [J]. European radiology, 2007, 17(2): 379-389.
[13]
曹益晟, 葛海燕. 早期结直肠癌局部切除与根治性术后生存比较 [J]. 世界华人消化杂志, 2016, (5): 801-807.
[14]
Clancy C, Burke JP, Albert MR, et al. Transanal endoscopic microsurgery versus standard transanal excision for the removal of rectal neoplasms: a systematic review and meta-analysis [J]. Dis Colon Rectum, 2015, 58(2): 254-261.
[15]
Saraste D, Gunnarsson U, Janson M. Predicting lymph node metastases in early rectal cancer [J]. Eur J Cancer, 2013, 49(5): 1104-1108.
[16]
Bach SP, Hill J, Monson JR, et al. A predictive model for local recurrence after transanal endoscopic microsurgery for rectal cancer [J]. Br J Surg, 2009, 96(3): 280-290.
[17]
Lee W, Lee D, Choi S, et al. Transanal endoscopic microsurgery and radical surgery for T1 and T2 rectal cancer [J]. Surg Endosc, 2003, 17(8): 1283-1287.
[18]
Beets GL, Figueiredo NF, Beets-Tan RG. Management of Rectal Cancer Without Radical Resection [J]. Annu Rev Med, 2017, 68: 169-182.
[19]
Amann M, Burghardt J, Stratz C, et al. Transanal endoscopic microsurgery in treatment of small rectal T1 high-risk, T2 and T3 carcinomas combined with radiochemotherapy [J]. European Surgery, 2015, 47(5): 226-237.
[20]
Chok KS, Law WL. Prognostic factors affecting survival and recurrence of patients with pT1 and pT2 colorectal cancer [J]. World J Surg, 2007, 31(7): 1485-1490.
[21]
Mellgren A, Sirivongs P, Rothenberger DA, et al. Is local excision adequate therapy for early rectal cancer? [J]. Dis Colon Rectum, 2000, 43(8): 1064-1071; discussion 71-74.
[22]
Garcia-Aguilar J, Renfro LA, Chow OS, et al. Organ preservation for clinical T2N0 distal rectal cancer using neoadjuvant chemoradiotherapy and local excision (ACOSOG Z6041): results of an open-label, single-arm, multi-institutional, phase 2 trial [J]. The Lancet Oncology, 2015, 16(15): 1537-1546.
[23]
Lezoche G, Baldarelli M, Guerrieri M, et al. A prospective randomized study with a 5-year minimum follow-up evaluation of transanal endoscopic microsurgery versus laparoscopic total mesorectal excision after neoadjuvant therapy [J]. Surg Endosc, 2008, 22(2): 352-358.
[24]
Borschitz T, Wachtlin D, Mohler M, et al. Neoadjuvant chemoradiation and local excision for T2-3 rectal cancer [J]. Ann Surg Oncol, 2008, 15(3): 712-720.
[25]
You YN, Roses RE, Chang GJ, et al. Multimodality salvage of recurrent disease after local excision for rectal cancer [J]. Dis Colon Rectum, 2012, 55(12): 1213-1219.
[26]
Doornebosch PG, Bronkhorst PJ, Hop WC, et al. The role of endorectal ultrasound in therapeutic decision-making for local vs. transabdominal resection of rectal tumors [J]. Diseases of the Colon & Rectum, 2008, 51(1): 38-42.
[27]
Doornebosch PG, Ferenschild FT, de Wilt JH, et al. Treatment of recurrence after transanal endoscopic microsurgery (TEM) for T1 rectal cancer [J]. Diseases of the Colon & Rectum, 2010, 53(9): 1234-1239.
[28]
Vaid S, Park JS, Sinnott RJ. Outcomes of Recurrent Rectal Cancer after Transanal Excision [J]. American Surgeon, 2016, 82(2): 152-155.
[29]
Perez RO, Habr-Gama A, Sao Juliao GP, et al. Transanal Endoscopic Microsurgery (TEM) Following Neoadjuvant Chemoradiation for Rectal Cancer: Outcomes of Salvage Resection for Local Recurrence [J]. Ann Surg Oncol, 2016, 23(4): 1143-1148.
[1] 代莉, 邓恢伟, 郭华静, 黄芙蓉. 术中持续输注艾司氯胺酮对腹腔镜结直肠癌手术患者术后睡眠质量的影响[J]. 中华普通外科学文献(电子版), 2023, 17(06): 408-412.
[2] 杜滨和, 徐楠, 杨云川, 崔培元. 5项改良衰弱指数预测胰十二指肠切除术近期预后的价值探讨[J]. 中华普通外科学文献(电子版), 2023, 17(06): 444-448.
[3] 王得晨, 杨康, 杨自杰, 归明彬, 屈莲平, 张小凤, 高峰. 结直肠癌微卫星稳定状态和程序性死亡、吲哚胺2,3-双加氧酶关系的研究进展[J]. 中华普通外科学文献(电子版), 2023, 17(06): 462-465.
[4] 唐旭, 韩冰, 刘威, 陈茹星. 结直肠癌根治术后隐匿性肝转移危险因素分析及预测模型构建[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 16-20.
[5] 张生军, 赵阿静, 李守博, 郝祥宏, 刘敏丽. 高糖通过HGF/c-met通路促进结直肠癌侵袭和迁移的实验研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 21-24.
[6] 张焱辉, 张蛟, 朱志贤. 留置肛管在中低位直肠癌新辅助放化疗后腹腔镜TME术中的临床研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 25-28.
[7] 李建美, 邓静娟, 杨倩. 两种术式联合治疗肝癌合并肝硬化门静脉高压的安全性及随访评价[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 41-44.
[8] 逄世江, 黄艳艳, 朱冠烈. 改良π形吻合在腹腔镜全胃切除消化道重建中的安全性和有效性研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 66-69.
[9] 杨体飞, 杨传虎, 陆振如. 改良无充气经腋窝入路全腔镜下甲状腺手术对喉返神经功能的影响研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 74-77.
[10] 陈垚, 徐伯群, 高志慧. 改良式中间上入路根治术治疗甲状腺癌的有效性安全性研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 619-622.
[11] 陈大敏, 曹晓刚, 曹能琦. 肥胖对胃癌患者手术治疗效果的影响研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 651-653.
[12] 李婷, 张琳. 血清脂肪酸代谢物及维生素D水平与结直肠癌发生的关系研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 661-665.
[13] 付振保, 曹万龙, 刘富红. 腹腔镜直肠癌低位前切除术中不同缝合方法的回肠双腔造口术临床效果研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 684-687.
[14] 贺亮, 王松林, 周业江. 两种预防性回肠造口在腹腔镜ISR术治疗超低位直肠癌的效果对比研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 697-700.
[15] 叶晋生, 路夷平, 梁燕凯, 于淼, 冀祯, 贺志坚, 张洪海, 王洁. 腹腔镜下应用生物补片修补直肠术后盆底缺损的疗效[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 688-691.
阅读次数
全文


摘要