Total Mesorectum Excision And Lateral Lymph Node Dissection COX Analysis For The Prognosis Of Patients With Low Rectal Cancer

Objective:To analysis of total mesorectum excision and lateral pelvic lymph node dissection effect on the prognosis of low rectal cancer patients;Evaluation the value in total mesorectum excision who had undergone lateral lymph node dissection;Study the different risk factors of postoperative outcomes in low rectal cancer patients.Methods:Choose a tertiary hospital in January 2010-January 2012 109 cases diagnosed by pathology and treated in sradical resection of low rectal cancer patients as the research object.Through the review case data and telephone follow-up,collected the clinical data and statistics.Divided cases of low rectal cancer whice information is complete on the basis of surgical way into two groups:total mesorectum excision and total mesorectum excision who had undergone lateral pelvic lymph node dissection.First,compare the two groups of postoperative distant metastasis and local recurrence,survival rate,micturition function and sexual function differences(sexual function comparison only men),and then using the COX model analyse the relationship between gender;age;tumor from the dentate line distance;infiltrating dept;The degree of differentiation;tumor diameter;lymph node metastasis number;operation way;ircumference and depth of penetration,Clinical stage and prognosis of low rectal cancer.Results:Total mesorectum excision who had undergone lateral pelvic lymph node dissection group on the distant metastasis and local recurrence and survival rate was better than total mesorectum excision group,with statistic difference(P<0.05),postoperative micturition function,sexual function was no significant difference(P>0.05).Single factor analysis results show that the total mesorectum excision who had undergone lateral pelvic lymph node dissection the risk factors affecting the prognosis of low rectal cancer patients.But COX model after analyzing many factors,the results show only Clinical stage,lymph node metastasis number,infiltrating depth,circumference and depth of penetration,tumor diameter are independent risk factors affecting the long-term survival of low rectal cancerpatients.Conclusion:1.Total mesorectum excision who had undergone lateral pelvic lymph node dissection can improve the prognosis of low rectal cancer patients,but not independent risk factors affecting the long-term survival of low rectal cancer patients.2.Low rectal cancer patients total mesorectum excision who had undergone lateral pelvic lymph node dissection group of distant metastasis,postoperative local recurrence and survival rate is better than total mesorectum excision group,but no difference between the two groups of postoperative quality of life.3.Clinical stage;lymph node metastasis number;infiltrating depth circumference and depth of penetration;tumor diameter related to the Long-term survival after surgery of low rectal cancer.