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The abdominoperineal resection itself is associated with an adverse outcome: the European experience based on a pooled analysis of five European randomised clinical trials on rectal cancer.
腹会阴切除术本身与不良结果相关: 欧洲经验基于对五项欧洲直肠癌随机临床试验的汇总分析。

摘要

PURPOSE:The aim of this study is to identify factors associated with the decision to perform an abdominoperineal resection (APR) and to assess if these factors or the surgical procedure itself is associated with circumferential resection margin (CRM) involvement, local recurrence (LR), overall survival (OS) and cancer-specific survival (CSS).
PATIENTS AND METHODS:The Swedish Rectal Cancer Trial (SRCT), TME trial, CAO/ARO/AIO-94 trial, EORTC 22921 trial and Polish Rectal Cancer Trial (PRCT) were pooled. A propensity score was calculated, which indicated the predicted probability of undergoing an APR given gender, age and distance, and used in the multivariate analyses.
RESULTS:An APR procedure was associated with an increased risk of CRM involvement [odd ratio (OR) 2.52, p<0.001], increased LR rate [hazard ratio (HR) 1.53, p=0.001] and decreased CSS rate (HR 1.31, p=0.002), whereas the propensity score was not.
CONCLUSION:The results suggest that the APR procedure itself is a significant predictor for non-radical resections and increased risk of LR and death due to cancer for patients with advanced rectal cancer.

译文

目的: 本研究的目的是确定决定进行腹会阴联合切除术 (APR) 的相关因素并评估这些因素或手术过程本身是否与环周切缘 (CRM) 受累、局部复发 (LR) 、总生存期 (OS) 相关和癌症特异性生存 (CSS)。
患者和方法: 合并瑞典直肠癌试验 (SRCT) 、 TME 试验、 CAO/ARO/AIO-94 试验、 EORTC 22921 试验和波兰直肠癌试验 (PRCT)。计算倾向得分,该得分表明在给定性别、年龄和距离的情况下进行 APR 的预测概率,并用于多变量分析。
结果: APR 程序与 CRM 参与风险的增加相关 [奇数比 (OR) 2.52,p <0.001],增加的 LR 率 [风险比 (HR) 1.53, p = 0.001] 和减少的 CSS 率 (HR 1.31,p = 0.002),而倾向得分没有。
结论: 结果表明,APR 手术本身是晚期直肠癌患者非根治性切除术和 LR 风险增加以及癌症死亡的重要预测因素。

Abdominoperineal Resection

消化 直肠癌治疗 手术
概述  :  

腹会阴联合切除术,又称Miles手术,是治疗低位直肠癌不保肛手术的标准术式。适用于肿瘤位置非常低或括约肌功能差的患者,该手术需完全切除结肠末端与直肠及肛门括约肌复合体,切除范围包括乙状结肠远端、全部直肠、肠系膜下动脉及其区域淋巴结、全直肠系膜、肛提肌、坐骨直肠窝内脂肪、肛管及肛门周围约5cm直径的皮肤、皮下组织及全部肛门括约肌,于左下腹行永久性乙状结肠单腔造口。 适应症腹膜返折以下的直肠癌,肿瘤下缘距齿线6cm以内的(如肿瘤分化低,局部浸润深,可延长到8cm以内),且无远距离转移者

abdominoperineal  [æb'dɔminə,peri'ni:əl]

释义   adj. 腹会阴的

例句   Among locally advanced rectal/rectosigmoid cases, surgery included abdominoperineal resection or low anterior resection.

局部进展性直肠/直肠乙状结肠病例,手术治疗包括腹会阴联合切除术或低位前切除术。

 

resection 英 [rɪ'sekʃn] 美 [rɪ'sekʃn]

释义   n. [外科] 切除术

例句   Local residual early cancer after endoscopic resection

内镜切除后局部残留早期癌症


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