• 1.四川省腫瘤醫(yī)院乳腺科(成都610041);;
  • 2.四川大學(xué)華西醫(yī)院肛腸外科(成都610041);

目的 　 探討直腸癌前切除術(shù)后局部復(fù)發(fā)癌的外科綜合治療方法。
方法 　收集近年來國內(nèi)、外有關(guān)直腸癌局部復(fù)發(fā)外科綜合治療進展的文獻并作一綜述。
結(jié)果 　積極有效的外科手術(shù)結(jié)合放、化療是提高患者生存率的主要途徑。
結(jié)論 　對于直腸癌前切除術(shù)后局部復(fù)發(fā)癌應(yīng)采用個體化的外科綜合治療方案，以延長患者的生存時間，改善癥狀，提高生存質(zhì)量。

引用本文： 田超,孟文建,李立. 直腸癌前切除術(shù)后局部復(fù)發(fā)的綜合治療進展. 中國普外基礎(chǔ)與臨床雜志, 2008, 15(9): 661-664. doi: 復(fù)制

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2. 　Temple WJ, Saettler EB. Locally recurrent rectal cancer: role of composite resection of extensive pelvic tumors with strategies for minimizing risk of recurrence [J]. J Surg Oncol, 2000; 73(1)∶47.
3. 　Saito N, Koda K, Takiguchi N, et al. Curative surgery for local pelvic recurrence of rectal cancer [J]. Dig Surg, 2003; 20(3)∶192.
4. 　Rdel C, Grabenbauer GG, Matzel KE, et al. Extensive surgery after high-dose preoperative chemoradiotherapy for locally advanced recurrent rectal cancer [J]. Dis Colon Rectum, 2000; 43(3)∶312.
5. 　Wiig JN, Larsen SG, Dueland S, et al. Preoperative irradiation and surgery for local recurrence of rectal and rectosigmoid cancer. Prognostic factors with regard to survival and further local recurrence [J]. Colorectal Dis, 2008; 10(1)∶48.
6. 　Hahnloser D, Nelson H, Gunderson LL, et al. Curative potential of multimodality therapy for locally recurrent rectal cancer [J]. Ann Surg, 2003; 237(4)∶502.
7. 　Visser O, Bakx R, Zoetmulder FA, et a1. The influence of total mesorectal excision on local recurrence and survival in rectal cancer patients: a population-based study in Greater Amsterdam [J]. J Surg Oncol, 2007; 95(6)∶447.
8. 　Edwards DP, Sexton R, Heald RJ, et al. Long-term results show triple stapling facilitates safe low colorectal and coloanal anastomosis and is associated with low rates of local recurrence after anterior resection for rectal cancer [J]. Tech Coloproctol, 2007; 11(1)∶17.
9. 　Heriot AG, Tekkis PP, Darzi A, et al. Surgery for local recurrence of rectal cancer [J]. Colorectal Dis, 2006; 8(9)∶733.
10. 　Garcia-Aguilar J, Cromwell JW, Marra C, et al. Treatment of locally recurrent rectal cancer [J]. Dis Colon Rectum, 2001; 44(12)∶1743.
11. 　Kendal WS, Cripps C, Viertelhausen S, et al. Multimodality management of locally recurrent colorectal cancer [J]. Surg Clin North Am, 2002; 82(5)∶1059.
12. 　Kobayashi A, Sugito M, Ito M, et al. Predictors of successful salvage surgery for local pelvic recurrence of rectosigmoid colon and rectal cancers [J]. Surg Today, 2007; 37(10)∶853.
13. 　Miner TJ, Jaques DP, Paty PB, et al. Symptom control in patients with locally recurrent rectal cancer [J]. Ann Surg Oncol, 2003; 10(1)∶72.
14. 　劉金林, 肖谷欣. 直腸癌前切除術(shù)后吻合口復(fù)發(fā)的原因分析（附91例報告）　[J]. 中國普外基礎(chǔ)與臨床雜志, 2003; 10(3)∶111.
15. 　Park IJ, Kim HC, Yu CS, et al. Effect of adjuvant radiotherapy on local recurrence in stage Ⅱ rectal cancer [J]. Ann Surg Oncol, 2008; 15(2)∶519.
16. 　Stevens G, Firth I, Solomon M, et al. Rectal cancer: changing patterns of referral for radiation therapy 1982-1997 [J]. Aust N Z J Surg, 2002; 70(8)∶553.
17. 　Mohiuddin M, Marks G, Marks J. Long-term results of reirradiation for patients with recurrent rectal carcinoma [J]. Cancer, 2002; 95(5)∶1144.
18. 　Hashiguchi Y, Sekine T, Kato S, et al. Indicators for surgical resection and intraoperative radiation therapy for pelvic recurrence of colorectal cancer [J]. Dis Colon Rectum, 2003; 46(1)∶31.
19. 　Syk E, Torkzad MR, Blomqvist L, et al. Radiological findings do not support lateral residual tumour as a major cause of local recurrence of rectal cancer [J]. Br J Surg, 2006; 93(1)∶113.
20. 　Rasmussen PC, Jakobsen AK. Treatment of local recurrence of rectal cancer [J]. Ugeskr Laeger, 2005; 167(45)∶4266.
21. 　Penna C, Nordlinger B. Colorectal metastasis (liver and lung) [J]. Surg Clin North Am, 2002; 82(5)∶1075.
22. 　Minsky BD. Adjuvant therapy for rectal cancer〖CD2〗the transatlantic view [J]. Colorectal Dis, 2003; 5(5)∶416.
23. 　Hansen MH, Kjaeve J, Revhaug A, et al. Impact of radiotherapy on local recurrence of rectal cancer in Norway [J]. Br J Surg, 2007; 94(1)∶113.
24. 　Kim NK, Baik SH, Seong JS, et al. Oncologic outcomes after neoadjuvant chemoradiation followed by curative resection with tumor-specific mesorectal excision for fixed locally advanced rectal cancer: Impact of postirradiated pathologic downstaging on local recurrence and survival [J]. Ann Surg, 2006; 244(6)∶1024.
25. 　Gotoh J, Akabane H, Kita K, et al. A case of local recurrence of rectal cancer in long-term responding to combined therapy of low-dose CPT-11 and 5’-DFUR [J]. Gan To Kagaku Ryoho, 2006; 33(9)∶1349.
26. 　Hoff PM, Ansari R, Batist G, et al. Comparison of oral ca-pecitabine versus intravenous fluorouracil plus leucovorin as first-line treatment in 605 patients with metastatic colorectal cancer: results of a randomized phase Ⅲ study [J]. J Clin Oncol, 2001; 19(8)∶2282.
27. 　Van Cutsem E, Twelves C, Cassidy J, et al. Oral capecitabine compared with intravenous fluorouracil plus leucovorin in patients with metastatic colorectal cancer: results of a large phase Ⅲ study [J]. J Clin Oncol, 2001; 19(21)∶4097.
28. 　Wiltshire KL, Ward IG, Swallow C, et al. Preoperative radiation with concurrent chemotherapy for resectable rectal cancer: effect of dose escalation on pathologic complete response, local recurrence-free survival, disease-free survival, and overall survival [J]. Int J Radiat Oncol Biol Phys, 2006; 64(3)∶709.
29. 　Ruers TJ, Joosten J, Jager GJ, et al. Long-term results of treating hepatic colorectal metastases with cryosurgery [J]. Br J Surg, 2001; 88(6)∶844.
30. 　Parikh AA, Curley SA, Fornage BD, et al. Radiofrequency ablation of hepatic metastases [J]. Semin Oncol, 2002; 29(2)∶168.
  1. 1. 　Radice E, Dozois RR. Locally recurrent rectal cancer [J]. Dig Surg， 2001; 18(5)∶355.
  2. 2. 　Temple WJ, Saettler EB. Locally recurrent rectal cancer: role of composite resection of extensive pelvic tumors with strategies for minimizing risk of recurrence [J]. J Surg Oncol, 2000; 73(1)∶47.
  3. 3. 　Saito N, Koda K, Takiguchi N, et al. Curative surgery for local pelvic recurrence of rectal cancer [J]. Dig Surg, 2003; 20(3)∶192.
  4. 4. 　Rdel C, Grabenbauer GG, Matzel KE, et al. Extensive surgery after high-dose preoperative chemoradiotherapy for locally advanced recurrent rectal cancer [J]. Dis Colon Rectum, 2000; 43(3)∶312.
  5. 5. 　Wiig JN, Larsen SG, Dueland S, et al. Preoperative irradiation and surgery for local recurrence of rectal and rectosigmoid cancer. Prognostic factors with regard to survival and further local recurrence [J]. Colorectal Dis, 2008; 10(1)∶48.
  6. 6. 　Hahnloser D, Nelson H, Gunderson LL, et al. Curative potential of multimodality therapy for locally recurrent rectal cancer [J]. Ann Surg, 2003; 237(4)∶502.
  7. 7. 　Visser O, Bakx R, Zoetmulder FA, et a1. The influence of total mesorectal excision on local recurrence and survival in rectal cancer patients: a population-based study in Greater Amsterdam [J]. J Surg Oncol, 2007; 95(6)∶447.
  8. 8. 　Edwards DP, Sexton R, Heald RJ, et al. Long-term results show triple stapling facilitates safe low colorectal and coloanal anastomosis and is associated with low rates of local recurrence after anterior resection for rectal cancer [J]. Tech Coloproctol, 2007; 11(1)∶17.
  9. 9. 　Heriot AG, Tekkis PP, Darzi A, et al. Surgery for local recurrence of rectal cancer [J]. Colorectal Dis, 2006; 8(9)∶733.
  10. 10. 　Garcia-Aguilar J, Cromwell JW, Marra C, et al. Treatment of locally recurrent rectal cancer [J]. Dis Colon Rectum, 2001; 44(12)∶1743.
  11. 11. 　Kendal WS, Cripps C, Viertelhausen S, et al. Multimodality management of locally recurrent colorectal cancer [J]. Surg Clin North Am, 2002; 82(5)∶1059.
  12. 12. 　Kobayashi A, Sugito M, Ito M, et al. Predictors of successful salvage surgery for local pelvic recurrence of rectosigmoid colon and rectal cancers [J]. Surg Today, 2007; 37(10)∶853.
  13. 13. 　Miner TJ, Jaques DP, Paty PB, et al. Symptom control in patients with locally recurrent rectal cancer [J]. Ann Surg Oncol, 2003; 10(1)∶72.
  14. 14. 　劉金林, 肖谷欣. 直腸癌前切除術(shù)后吻合口復(fù)發(fā)的原因分析（附91例報告）　[J]. 中國普外基礎(chǔ)與臨床雜志, 2003; 10(3)∶111.
  15. 15. 　Park IJ, Kim HC, Yu CS, et al. Effect of adjuvant radiotherapy on local recurrence in stage Ⅱ rectal cancer [J]. Ann Surg Oncol, 2008; 15(2)∶519.
  16. 16. 　Stevens G, Firth I, Solomon M, et al. Rectal cancer: changing patterns of referral for radiation therapy 1982-1997 [J]. Aust N Z J Surg, 2002; 70(8)∶553.
  17. 17. 　Mohiuddin M, Marks G, Marks J. Long-term results of reirradiation for patients with recurrent rectal carcinoma [J]. Cancer, 2002; 95(5)∶1144.
  18. 18. 　Hashiguchi Y, Sekine T, Kato S, et al. Indicators for surgical resection and intraoperative radiation therapy for pelvic recurrence of colorectal cancer [J]. Dis Colon Rectum, 2003; 46(1)∶31.
  19. 19. 　Syk E, Torkzad MR, Blomqvist L, et al. Radiological findings do not support lateral residual tumour as a major cause of local recurrence of rectal cancer [J]. Br J Surg, 2006; 93(1)∶113.
  20. 20. 　Rasmussen PC, Jakobsen AK. Treatment of local recurrence of rectal cancer [J]. Ugeskr Laeger, 2005; 167(45)∶4266.
  21. 21. 　Penna C, Nordlinger B. Colorectal metastasis (liver and lung) [J]. Surg Clin North Am, 2002; 82(5)∶1075.
  22. 22. 　Minsky BD. Adjuvant therapy for rectal cancer〖CD2〗the transatlantic view [J]. Colorectal Dis, 2003; 5(5)∶416.
  23. 23. 　Hansen MH, Kjaeve J, Revhaug A, et al. Impact of radiotherapy on local recurrence of rectal cancer in Norway [J]. Br J Surg, 2007; 94(1)∶113.
  24. 24. 　Kim NK, Baik SH, Seong JS, et al. Oncologic outcomes after neoadjuvant chemoradiation followed by curative resection with tumor-specific mesorectal excision for fixed locally advanced rectal cancer: Impact of postirradiated pathologic downstaging on local recurrence and survival [J]. Ann Surg, 2006; 244(6)∶1024.
  25. 25. 　Gotoh J, Akabane H, Kita K, et al. A case of local recurrence of rectal cancer in long-term responding to combined therapy of low-dose CPT-11 and 5’-DFUR [J]. Gan To Kagaku Ryoho, 2006; 33(9)∶1349.
  26. 26. 　Hoff PM, Ansari R, Batist G, et al. Comparison of oral ca-pecitabine versus intravenous fluorouracil plus leucovorin as first-line treatment in 605 patients with metastatic colorectal cancer: results of a randomized phase Ⅲ study [J]. J Clin Oncol, 2001; 19(8)∶2282.
  27. 27. 　Van Cutsem E, Twelves C, Cassidy J, et al. Oral capecitabine compared with intravenous fluorouracil plus leucovorin in patients with metastatic colorectal cancer: results of a large phase Ⅲ study [J]. J Clin Oncol, 2001; 19(21)∶4097.
  28. 28. 　Wiltshire KL, Ward IG, Swallow C, et al. Preoperative radiation with concurrent chemotherapy for resectable rectal cancer: effect of dose escalation on pathologic complete response, local recurrence-free survival, disease-free survival, and overall survival [J]. Int J Radiat Oncol Biol Phys, 2006; 64(3)∶709.
  29. 29. 　Ruers TJ, Joosten J, Jager GJ, et al. Long-term results of treating hepatic colorectal metastases with cryosurgery [J]. Br J Surg, 2001; 88(6)∶844.
  30. 30. 　Parikh AA, Curley SA, Fornage BD, et al. Radiofrequency ablation of hepatic metastases [J]. Semin Oncol, 2002; 29(2)∶168.