Reoperation for Local Recurrence of Rectal Cancer（Analysis of 56 Cases）_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 WANG Haijiang , ZHAO Zeliang , SUN Zhenqiang , LIU Lin

Department of Gastrointestinal Surgery， Affiliated Tumor Hospital， Xinjiang Medical University， Urumchi 830011， Xinjiang， China;

Corresponding author：

WANG Haijiang, Email: wanghaijiang@medmail.com.cn

Keywords：

Rectal cancer; Local recurrence; Operative treatment; Survival time

Video：

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Objective 　To approach the surgical therapeutic efficacy of local recurrence of rectal cancer.
Methods Fifty-six patients with local recurrence of rectal cancer suffered from reoperation from January 2003 to January
2011 in this hospital were collected. Chi-square test was performed to analyze the complete excision rates of reoperation for different recurrent time after radical resection and different surgical procedures after primary radical resection of rectal
cancer. The method of log-rank test was used for survival analysis of the Miles and Dixon procedure.
Results 　①The opera-tion time and intraoperative bleeding of reoperation for local recurrence of rectal cancer were more than those of the primary radical resection of rectal cancer （P＜0.05）. ②The complete resection rate of the local recurrence of rectal cancer in 5 years after primary radical resection of rectal cancer was higher than that of the local recurrence of rectal cancer within 2 years after primary radical resection of rectal cancer， and the difference was statistically significant （P＜0.01）. ③The complete resection rate of the local recurrence of rectal cancer of the technique of Dixon in the primary radical resection of rectal cancer was higher than that of Miles， and the difference was statistically significant （P＜0.05）. ④The median survival time and 2-year survival rate and 5-year survival rate of the technique of Dixon in the reoperation were longer or higher than those of Miles， and the differences were statistically significant （P＜0.05）.
Conclusions 　Surgical procedure and postoperative recurrence time after primary operation can both influence complete excision rate of reoperation for local recurrence of rectal cancer. And reoperation for local recurrence of rectal cancer can prolong the survival time.

Citation： WANG Haijiang,ZHAO Zeliang,SUN Zhenqiang,LIU Lin,.. Reoperation for Local Recurrence of Rectal Cancer（Analysis of 56 Cases）. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2013, 20(11): 1224-1227. doi: Copy

1.	陈万青，张思维，郑荣寿，等. 中国肿瘤登记地区2007年肿瘤发病和死亡分析[J]. 中国肿瘤， 2011， 20(3)：162-169.
2.	巫佳明，刘桂，钟其生. 直肠癌术后复发再手术治疗的临床分析[J]. 中国肿瘤临床与康复， 2005， 12(4)：364-365.
3.	乔唐，柏斗胜，徐永建. 直肠癌Dixon术后局部复发原因及防治探讨[J]. 实用临床医药杂志， 2004， 8(2)：79-80.
4.	Baek SJ， Kim SH， Kwak JM， et al. Selective use of preoperative chemoradiotherapy for T3 rectal cancer can be justified：analysis of local recurrence[J]. World J Surg， 2013， 37(1)：220-226.
5.	Arredondo J， Baixauli J， Beorlegui C， et al. Prognosis factors for recurrence in patients with locally advanced rectal cancer preoperatively treated with chemoradiotherapy and adjuvant chemotherapy[J]. Dis Colon Rectum， 2013， 56(4)：416-421.
6.	Heald RJ， Smedh RK， Kald A， et al. Abdominoperineal excision of the rectum endangered operation[J]. Dis Colon Rectum， 1997， 40(7)：747-751.
7.	韩加刚，李志霞. 直肠癌的术前短期放射治疗[J]. 国外医学：外科学分册， 2004， 31(3)：164-167.
8.	Akiyoshi T， Watanabe T， Ueno M. Is lateral pelvic lymph node dissection no longer necessary for low rectal cancer after neoadjuvant therapy and TME to reduce local recurrence?[J]. J Gastrointest Surg， 2012， 16(12)：2341-2342.
9.	Guillem JG， Paty PB， Cohen AM. Surgical treatment of colorectalcancer[J]. CA Cancer J Clin， 1997， 47(2)：113-128.
10.	Law WL， Chu KW. Resection of local recurrence of rectal cancer：results[J]. World J Surg， 2000， 24(4)：486-490.
11.	Fuyi Z， Bo Y， Zhengjia L， et al. Long term observation of 367 cases of radical excision with anus preservation by casing anastomosis in low-rectal cancers[J]. Hepatogastroenterology， 2013， 60(124)：738-740.
12.	毛捷鸿，李小沛. 直肠癌术后局部复发的再手术治疗(附25例报告)[J]. 中国普通外科杂志， 2001， 10(3)：237-240.
13.	Melton GB， Paty PB， Boland PJ， et al. Sacral resection for recu-rrent rectal cancer：analysis of morbidity and treatment results[J]. Dis Colon Rectum， 2006， 49(8)：1099-1107.
14.	Arredondo J， Miccini M， Borghese O， et al. Anastomotic leakageand septic complications：impact on local recurrence in surgery of low rectal cancer[J]. Ann Ital Chir， 2011， 82(2)：117-123.
15.	万德森. 低位直肠癌保肛手术后局部复发的对策[J]. 中华胃肠外科杂志， 2010， 13(8)：557-561.
16.	Park JK， Kim YW， Hur H， et al. Prognostic factors affectingoncologic outcomes in patients with locally recurrent rectal cancer：impact of patterns of pelvic recurrence on curative resection[J]. Langenbecks Arch Surg， 2009， 394(1)：71-77.
17.	Rudmik LR， Buie WD， Heine JA. Reoperation for intraluminal rectal cancer recurrence[J]. Dis Colon Rectum， 2005， 48(9)：1752-1754.
18.	李保卫，申连东，任宏. 直肠癌术后局部复发再手术50例分析[J]. 陕西医学杂志， 2010， 39(10)：1424.
19.	Henry LR， Sigurdson E， Ross E， et al. Hydronephrosis does not preclude curative resection of pelvic recurrences after colorectal surgery[J]. Ann Surg Oncol， 2005， 12(10)：786-792.
20.	傅传刚，高显华. 局部复发直肠癌再手术适应证及手术方式的选择[J]. 中国实用外科杂志， 2011， 31(4)：287-289.
21.	Mirnezami AH， Sagar PM. Surgery for recurrent rectal cancer：technical notes and management of complications[J]. Tech Coloproctol， 2010， 14(3)：209-216.
22.	Garcia-Aguilar J， Cromwell JW， Marra C， et al. Treatment of locally recurrent rectal cancer[J]. Dis Colon Rectum， 2001， 44(12)：1743-1748.

1. 陈万青，张思维，郑荣寿，等. 中国肿瘤登记地区2007年肿瘤发病和死亡分析[J]. 中国肿瘤， 2011， 20(3)：162-169.
2. 巫佳明，刘桂，钟其生. 直肠癌术后复发再手术治疗的临床分析[J]. 中国肿瘤临床与康复， 2005， 12(4)：364-365.
3. 乔唐，柏斗胜，徐永建. 直肠癌Dixon术后局部复发原因及防治探讨[J]. 实用临床医药杂志， 2004， 8(2)：79-80.
4. Baek SJ， Kim SH， Kwak JM， et al. Selective use of preoperative chemoradiotherapy for T3 rectal cancer can be justified：analysis of local recurrence[J]. World J Surg， 2013， 37(1)：220-226.
5. Arredondo J， Baixauli J， Beorlegui C， et al. Prognosis factors for recurrence in patients with locally advanced rectal cancer preoperatively treated with chemoradiotherapy and adjuvant chemotherapy[J]. Dis Colon Rectum， 2013， 56(4)：416-421.
6. Heald RJ， Smedh RK， Kald A， et al. Abdominoperineal excision of the rectum endangered operation[J]. Dis Colon Rectum， 1997， 40(7)：747-751.
7. 韩加刚，李志霞. 直肠癌的术前短期放射治疗[J]. 国外医学：外科学分册， 2004， 31(3)：164-167.
8. Akiyoshi T， Watanabe T， Ueno M. Is lateral pelvic lymph node dissection no longer necessary for low rectal cancer after neoadjuvant therapy and TME to reduce local recurrence?[J]. J Gastrointest Surg， 2012， 16(12)：2341-2342.
9. Guillem JG， Paty PB， Cohen AM. Surgical treatment of colorectalcancer[J]. CA Cancer J Clin， 1997， 47(2)：113-128.
10. Law WL， Chu KW. Resection of local recurrence of rectal cancer：results[J]. World J Surg， 2000， 24(4)：486-490.
11. Fuyi Z， Bo Y， Zhengjia L， et al. Long term observation of 367 cases of radical excision with anus preservation by casing anastomosis in low-rectal cancers[J]. Hepatogastroenterology， 2013， 60(124)：738-740.
12. 毛捷鸿，李小沛. 直肠癌术后局部复发的再手术治疗(附25例报告)[J]. 中国普通外科杂志， 2001， 10(3)：237-240.
13. Melton GB， Paty PB， Boland PJ， et al. Sacral resection for recu-rrent rectal cancer：analysis of morbidity and treatment results[J]. Dis Colon Rectum， 2006， 49(8)：1099-1107.
14. Arredondo J， Miccini M， Borghese O， et al. Anastomotic leakageand septic complications：impact on local recurrence in surgery of low rectal cancer[J]. Ann Ital Chir， 2011， 82(2)：117-123.
15. 万德森. 低位直肠癌保肛手术后局部复发的对策[J]. 中华胃肠外科杂志， 2010， 13(8)：557-561.
16. Park JK， Kim YW， Hur H， et al. Prognostic factors affectingoncologic outcomes in patients with locally recurrent rectal cancer：impact of patterns of pelvic recurrence on curative resection[J]. Langenbecks Arch Surg， 2009， 394(1)：71-77.
17. Rudmik LR， Buie WD， Heine JA. Reoperation for intraluminal rectal cancer recurrence[J]. Dis Colon Rectum， 2005， 48(9)：1752-1754.
18. 李保卫，申连东，任宏. 直肠癌术后局部复发再手术50例分析[J]. 陕西医学杂志， 2010， 39(10)：1424.
19. Henry LR， Sigurdson E， Ross E， et al. Hydronephrosis does not preclude curative resection of pelvic recurrences after colorectal surgery[J]. Ann Surg Oncol， 2005， 12(10)：786-792.
20. 傅传刚，高显华. 局部复发直肠癌再手术适应证及手术方式的选择[J]. 中国实用外科杂志， 2011， 31(4)：287-289.
21. Mirnezami AH， Sagar PM. Surgery for recurrent rectal cancer：technical notes and management of complications[J]. Tech Coloproctol， 2010， 14(3)：209-216.
22. Garcia-Aguilar J， Cromwell JW， Marra C， et al. Treatment of locally recurrent rectal cancer[J]. Dis Colon Rectum， 2001， 44(12)：1743-1748.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Reoperation for Local Recurrence of Rectal Cancer（Analysis of 56 Cases）

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