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直腸癌手術359例中38例 (10.6%) に肉眼的に隣接臓器への浸潤が認められた. si (Ai) 38例中Si (Ai) 単独因子のものは27例 (71%), 浸潤隣接臓器を合併切除したものが23例 (61%) で, うち20例 (87%) に根治手術が施行できた. 根治手術例の5年生存率は44.2%であり, 積極的に合併切除を施行すべきと考える.腟浸潤例は腟部分切除術7例中6例に, 腟亜全摘出術2例中1例に局所再発を生じた. 膀胱浸潤例は膀胱部分切除術を2例に, 骨盤内臓器全摘出術を4例に施行したが局所再発を1例も認めず, 肺再発を1例に認めたのみであった. したがって膀胱浸潤例では膀胱合併切除により遠隔成績を向上させることができるが, 腟浸潤例では局所再発が多く, より広範な腟切除が必要と考えられる.

Combined resection of adjacent organs in treatment of rectal cancer.