全盆腔脏器联合切除术治疗盆部肿瘤45例分析
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摘要
目的探讨全盆腔脏器联合切除术在盆部肿瘤治疗中的作用。方法回顾分析2002年1月至2013年12月收治的盆腔内浸润广泛转移的直肠癌、宫颈癌、膀胱癌、盆腔巨大恶性软组织肿瘤共45例行全盆腔脏器切除术治疗的临床资料。结果直肠癌26例中16例根治性切除,10例行姑息性切除,术后1、3、5年生存率分别为53.8%(14/26)、30.7%(8/26)、15.3%(4/26)。子宫颈癌9例术后1、3年生存率为66.0%(6/9)、33.0%(3/9)。卵巢癌5例的1、3、5年生存率分别为100%(5/5)、60.0%(3/5)、40.0%(2/5)。结论 TPE虽然创伤大、危险性高,但是治疗盆腔内广泛浸润转移的直肠癌、宫颈癌、膀胱癌、盆腔巨大恶性软组织肿瘤等最有效的一种方法。
Objective To discuss the effect of total pelvic exenteration application for the pelvic tumor.Methods Method Retrospective analysis of clinical data from 2002 January to 2013 December were in total pelvic exenteration of 45 cases including rectal cancer,cervical cancer,bladder cancer,pelvic huge malignant soft tissue tumor of extensive infiltration metastasis. Results In 26 patients with rectal cancer,16 cases had undergone a radical surgical procedure and 10 patients had undergone a nonradical surgical procedure. 1,3,5-year survival rate distinguishes to 53. 8%( 14 /26) 、30. 7%( 8 /26) 、15. 3%( 4 /26). In the 9 patients of recurrent cervical carcinoma,the 1,3-year survival rate distinguishes to 66%( 6 /9) 、33%( 3 /9). In the 5 patients of recurrent ovary cancer,1,3,5-year survival rate distinguishes to 100%( 5 /5) 、60%( 3 /5) 、40%( 2 /5).Conclusions Although TPE is a high risk operation with big wound,it is effective for rectum cancer,cervices cancer,bladder cancer and pelvic huge malignant soft tissue tumor etc.
Objective To discuss the effect of total pelvic exenteration application for the pelvic tumor.Methods Method Retrospective analysis of clinical data from 2002 January to 2013 December were in total pelvic exenteration of 45 cases including rectal cancer,cervical cancer,bladder cancer,pelvic huge malignant soft tissue tumor of extensive infiltration metastasis. Results In 26 patients with rectal cancer,16 cases had undergone a radical surgical procedure and 10 patients had undergone a nonradical surgical procedure. 1,3,5-year survival rate distinguishes to 53. 8%( 14 /26) 、30. 7%( 8 /26) 、15. 3%( 4 /26). In the 9 patients of recurrent cervical carcinoma,the 1,3-year survival rate distinguishes to 66%( 6 /9) 、33%( 3 /9). In the 5 patients of recurrent ovary cancer,1,3,5-year survival rate distinguishes to 100%( 5 /5) 、60%( 3 /5) 、40%( 2 /5).Conclusions Although TPE is a high risk operation with big wound,it is effective for rectum cancer,cervices cancer,bladder cancer and pelvic huge malignant soft tissue tumor etc.
引文
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[6]刘东举,董晓红,赵立伟,等.全盆腔脏器联合切除术在腹部肿瘤外科中的应用[J].沈阳医学院学报,2013,15(3):149-151.
[7]Law WL,Chu KW,Choi HK.Total pelvic exenteration for locally advanced rectal cancer[J].J Am Coll Surg,2000,190(1):78-83.
[8]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.
[9]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.
[10]Kuhrt MP,Chokshi RJ,Arrese D,et al.Retrospective review of pelvic malignancies undergoing total pelvic exenteration[J].World J Surg Oncol,2012,10:110.
[2]Brunshwig A.Complete excision of pelvic viscera for advanced carcinoma[J].Cancer,1948,1(2):177-183.
[3]Appleby LH.Proctocystectomy;the management of colostomy with ureteraltransplants[J].Am J Surg,1950,79(1):57-60.
[4]Elder S,Kemeny MM,Terz JJ.Extended resection for carcinoma of the colon and rectum[J].Surg Gynecol Obstent,1985,161(4):319-322.
[5]王正康.当代大肠癌手术学[M].北京:北京医科大学、中国协和医科大学联合出版社,1994:212.
[6]刘东举,董晓红,赵立伟,等.全盆腔脏器联合切除术在腹部肿瘤外科中的应用[J].沈阳医学院学报,2013,15(3):149-151.
[7]Law WL,Chu KW,Choi HK.Total pelvic exenteration for locally advanced rectal cancer[J].J Am Coll Surg,2000,190(1):78-83.
[8]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.
[9]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.
[10]Kuhrt MP,Chokshi RJ,Arrese D,et al.Retrospective review of pelvic malignancies undergoing total pelvic exenteration[J].World J Surg Oncol,2012,10:110.