全盆腔脏器联合切除术在腹部肿瘤外科中的应用
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摘要
目的:探讨全盆腔脏器联合切除术(total pelvic exenteration,TPE)在腹部肿瘤外科中的应用。方法:2002至2012年应用TPE治疗盆腔内侵犯广泛的直肠癌、宫颈癌、膀胱癌、盆腔巨大恶性软组织肿瘤等恶性肿瘤,共完成TPE 40例。结果:直肠癌及复发直肠癌盆腔直接浸润转移癌21例中,术后1、3、5年生存率分别为62%(13/21)、33%(7/21)、19%(4/21)。子宫颈癌盆腔广泛转移9例中,1、3年生存率分别为66%(6/9)、33%(3/9)。卵巢癌盆腔广泛转移5例中,1、3、5年生存率分别为100%(5/5)、60%(3/5)、40%(2/5)。结论:TPE是创伤大、危险性高的手术,是治疗盆腔内侵犯广泛的直肠癌、宫颈癌、膀胱癌、盆腔巨大恶性软组织肿瘤等恶性肿瘤最有效的一种方法。
Obuective: To explore the application of total pelvic enenteration(TPE) in the surgery of abdomen tumor.Methods: From 2002 to 2012,TPE was done in 40 cases with basin antrum malignant tumors including rectal cancer,cervical cancer,bladder cancer and huge malignant soft tissue tumor etc.Results: In 21 cases with directly transfered cancer of rectal cancer and relapse rectal cancer,12 cases were cured and 9 cases with routine cut-off.Post-operative 1,3,5 years survival rate was 62%(13 / 21),33%(7 /21),19%(4 /21).In 9 cases with entensively transfered cancer of cervical cancer,post-operative 1,3 years survival rate was 66%(6 /9),33%(3 /9).In 5 cases with entensively transfered cancer of oophoroma,post-operative 1,3,5 years survival rate was 100%(5 /5),60%(3 /5),40%(2 /5).Conclusion: TPE is a operation with high damage and danger,and is the effective treatment of basin antrum malignancies.
Obuective: To explore the application of total pelvic enenteration(TPE) in the surgery of abdomen tumor.Methods: From 2002 to 2012,TPE was done in 40 cases with basin antrum malignant tumors including rectal cancer,cervical cancer,bladder cancer and huge malignant soft tissue tumor etc.Results: In 21 cases with directly transfered cancer of rectal cancer and relapse rectal cancer,12 cases were cured and 9 cases with routine cut-off.Post-operative 1,3,5 years survival rate was 62%(13 / 21),33%(7 /21),19%(4 /21).In 9 cases with entensively transfered cancer of cervical cancer,post-operative 1,3 years survival rate was 66%(6 /9),33%(3 /9).In 5 cases with entensively transfered cancer of oophoroma,post-operative 1,3,5 years survival rate was 100%(5 /5),60%(3 /5),40%(2 /5).Conclusion: TPE is a operation with high damage and danger,and is the effective treatment of basin antrum malignancies.
引文
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[7]万远廉,吴楠,刘玉村,等.应用盆腔脏器联合切除术治疗局部复发型直肠癌[J].中华胃肠外科杂志,2001,4(4):222-224
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[9]Law WL,Chu KW,Choi HK.Total pelvic exenteration for locally advanced rectal cancer[J].J Am Coll Surg,2000,190:78
[10]罗成华,宋少柏,李荣,等.盆腔脏器切除术治疗复发直肠癌[J].中华胃肠外科杂志,2003,6:85-88.
[2]Appleby LH.Proctocystectomy:the management of colostomy with ureteraltransplants[J].AmJSurg,1950,79(1):57-60.
[3]Elder S.Extended resection for carcinoma of the colon and rectal cancer.[J].Surg Gynecol Obstent,1985,161(4):319.
[4]Beoy J.Pelvic exenteration for locally advanced colorectual carcinoma[J].Ann Sury,1982,195(4):531.
[5]万远廉,姜勇.全盆腔脏器切除术在局部复发型直肠癌中的应用[J].中华胃肠外科杂志,2010,8(4):562-564
[6]罗成华,宋少柏,于俊兰,等.盆腔脏器切除术治疗复发直肠癌[J].中华胃肠外科杂志,2003,6(2):85-88
[7]万远廉,吴楠,刘玉村,等.应用盆腔脏器联合切除术治疗局部复发型直肠癌[J].中华胃肠外科杂志,2001,4(4):222-224
[8]Yamada K,Ishizawa T,Niwa K,et al.Pelvic exenteration andsacral resection for locally advanced primary and recurrent rectalcancer[J].Dis Colon Rectum,2002,45(8):1078-1084
[9]Law WL,Chu KW,Choi HK.Total pelvic exenteration for locally advanced rectal cancer[J].J Am Coll Surg,2000,190:78
[10]罗成华,宋少柏,李荣,等.盆腔脏器切除术治疗复发直肠癌[J].中华胃肠外科杂志,2003,6:85-88.