术前辅助放化疗对低位直肠癌患者保肛率及术后并发症的影响

Influence of preoperative chemoradiotherapy on sphincter preservation and postoperative complications in patients with low rectal carcinomas

目的探讨分析术前辅助化疗对低位直肠癌患者保肛率及术后并发症的影响。方法回顾性分析该院于2007年4月至2012年9月收治的90例低位直肠癌患者的临床资料,将接受术前辅助化疗的45例患者作为实验组,术前未进行辅助化疗的45例患者作为对照组。比较两组患者的手术情况,保肛率,术后并发症发生情况及手术前后的细胞免疫功能。结果实验组术中平均出血量(95.2±12.8)mL,平均手术时间(117.3±14.8)min,对照组术中平均出血量(98.4±14.6)mL,平均手术时间(121.5±15.2)min,两组手术时间与术中出血的比较差异无统计学意义(P>0.05);实验组的保肛率51.1%,对照组为11.1%,实验组高于对照组(P<0.05);实验组共6例患者术后发生并发症,对照组术后共3例患者发生并发症,两组患者术后并发症发生的情况对比差异无统计学意义(P>0.05);实验组与对照组手术前与术后一周细胞免疫功能比较差异无统计学意义(P>0.05)。结论术前辅助放化疗能够提高低位直肠癌患者的保肛率,不会增加术后并发症的发生率,且不会对患者的细胞免疫功能造成影响。

Objective To study the influence of preoperative chemoradiotherapy on sphincter preservation and postoperative complications in patients with low rectal carcinomas .Methods Clinical data of 90 patients with low rectal carcinomas in this hospital from 2007-2012 were retrospectively analyzed .45 patients receiving preoperative chemoradiotherapy were divided into experiment group ,while 45 patients who didn′t receive preoperative chemora-diotherapy were divided into control group .Intraoperative situation ,sphincter preservation ,postoperative complica-tions and cellular immune function before and after operation of the two groups were compared .Results There were no significant differences of mean amount of bleed [（95 .2 ± 12 .8） mL vs .（98 .4 ± 14 .6） mL ,P〉0 .05] ,mean opera-tive time [（117 .3 ± 14 .8） min vs .（121 .5 ± 15 .2）min ,P〉0 .05] ,incidences of postoperative complications （6 cases vs .3 cases ,P〉0 .05） and cellular immune function before and after the operation between the two groups .The sphincter preservation rate of experiment group was statistically higher than that of control group （51 .1% vs . 11 .1% ,P〈0 .05） .Conclusion Preoperative chemoradiotherapy could improve the sphincter preservation rate in pa-tients with low rectal carcinomas ,which would not increase the incidences of postoperative complications and damage the cellular immune function of patients .