术前放化疗对直肠癌根治术近期临床效果对比分析

Short-term Outcomes after Laparoscopic Surgery Following Preoperative Chemoradiotherapy for Rectal Cancer

目的比较术前是否放化疗对直肠癌根治术的近期临床疗效。方法回顾性分析2008年2月至2012年11月鸡泽县医院普外科由同一手术治疗组收治的72例行腹腔镜治疗(非放化疗组)和59例行术前放化疗后腹腔镜手术治疗的直肠癌患者(放化疗组)的临床资料。对术后患者的短期手术治疗效果进行分析。结果放化疗组比非放化疗组的手术时间长[(295.1±71.4)min vs(261.0±58.2)min](P<0.05),非放化疗组比放化疗组切除的肿瘤大[(4.1±1.5)cm vs(2.8±1.7)cm]、非放化疗组比放化疗组清扫的淋巴结数量多[(12.9±6.5)个vs(8.8±6.7)个](P<0.05),两组手术类型、肿瘤位置、并发症发病率、预防性造口术、组织学病理分期、两组之间距下切缘距离的差异无统计学意义(P>0.05)。结论对于直肠癌患者,在有术前放化疗条件的医院可以作为首选外科治疗方式,近期临床效果较好。

Objective To investigate the value of preoperative chemoradiotherapy after laparoscopic surgery for rectal cancer.Methods The clinical data of 131 patients with rectal cancer treated by General Surgery Department of Jize County People＇s Hospital during Feb.2008 and Nov.2012 were retrospectively analyzed.Among the patients,72 cases received laparoscopic surgery（non-CRT group）,and 59 cases received laparoscopic surgery following preoperative chemoradiotherapy（CRT group）.The short-term postoperative effects of the two groups were compared.Results The mean operation time was longer in the CRT group than the non-CRT group[（295.1 ± 71.4） min vs （261.0 ± 58.2） min]（P 〈 0.05）,the tumor sizes of non-CRT group were larger[（4.1 ± 1.5） cm vs （2.8 ± 1.7） cm]and more lymph nodes were dissected in non-CRT group[（12.9 ± 6.5） vs （8.8 ± 6.7）]（P 〈 0.05）.There was no significant difference between the two groups in surgery type,tumor location,complication incidence,preventive colostomy,histopathological stage and distance from the lower cutting edge（P 〉 0.05）.Conclusion Laparoscopic surgery following preoperative CRT is safe and feasible with good short-term clinical effect,and should be considered as the fistt-choice for patients with rectal cancer.