【摘要】 目的 探讨直肠癌术后复发的原因及诊断治疗方法。方法 对48例直肠癌术后复发病人进行回顾性分析。结果 吻合口处复发11例，会阴部复发8例，盆腔内复发12例，腹腔内复发10例，腹股沟处复发1例，肝脏转移5例，肺脏转移1例，手术后2年内复发33例(69%)；本组病例均再次行手术治疗，根治性切除率为56%(27/48)，姑息性切除率为44%(21/48)。结论 首次手术应根据直肠癌生物学特点，制定合理的以手术治疗为主的综合治疗方案，切除足够的直肠及其系膜。严格无瘤操作是预防直肠癌术后复发的主要措施。对复发病例应根据复发部位、病期早晚选择以手术为主的综合治疗方案。

    【关键词】 直肠癌；复发

    Clinical analysis of recurrent rectum cancer

    JIA Zhongming,LIU Yan,Wang Xilong

    Affiliated Hospital of Binzhou Medical College,Binzhou 256603

    【Abstract】 Objective To study the cause of local recurrence,diagnosis and treatment of recurrent rectum cancer.Methods Forty-eight cases of postoperative rectum cacinoma recurrence were retrospectively analyzed.Results Recurrence in anastomotic stoma,perineum,pelvic cavity,bdominal cavity and inguinal region were 11,8,12,10 and one cases respectively.Liver and lung metastasis were respectively five and one cases.Among them 33 cases (69%) had lung metastasis were respectively five and one cases.Among them 33 cases (69%) had recurrence within 2 years after orperations.Of 48 recurrent cases reoperated,curative surgery rate was 56%(27/48),and palliative operation rate was 44% (21/48).Conclusion For the first surgery,based on biological features of rectum cancer we should make reasonably integrative therapy strategies,of which surgical treatment is the major means.Resecting intestive of primary lesion enough,performing complete lymphadenectomy and eradicating peritoneal exfoliated cancer cells and micrometastatic lesions completely are the major measures to prevent recurrence rectum cancer after operation.Integrative therapy schemes,of which surgical treatment is the major means,should be considered according to the site of recurrence and the staging for the recurrence cases. ......