无瘤术用于直肠癌功能性扩大根治术的3年复发及生存率观察

Observation of 3 years recurrence and survival rate of no-tumor procedure applied into functional extending of the radical operation

目的观察无瘤术用于直肠癌功能性扩大根治术的3年复发率及生存率。方法回顾性分析我院2009-2013年收治的直肠癌患者临床资料60例,均同期行直肠癌功能性扩大根治术,按术中是否行无瘤术将其分为观察组和对照组各30例,比较两组手术时间、术中出血量、排气时间、住院时间,应用肿瘤患者生活质量评分表（QOL）分析两组术后1个月、3个月、1年、2年、3年生活质量,并采用Elisa法分析各时间点血管内皮生长因子C（VEGF-C）阳性率,同时比较两组术后3年复发率与生存率。结果观察组手术时间（53.23±3.17）min、术中出血量（0.41±0.13）L、排气时间（22.16±3.28）min、住院时间（19.36±4.02）d与对照组比较无统计学意义（P〉0.05）;观察组术后1个月、3个月、1年QOL评分与对照组比较无显著差异（P〉0.05）,术后2年、3年观察组QOL评分（48.43±3.27）分、（52.34±4.20）分明显高于对照组（P〈0.05）;观察组术后1年、2年、3年VEGF-C阳性率显著低于对照组（P〈0.05）;术后3年观察组复发率6.7%与对照组16.7%比较显著较低（P〈0.05）,观察组术后3年生存率90.0%与对照组66.7%比较显著较高（P〈0.05）。结论无瘤术用于直肠癌功能性扩大根治术近期疗效不显著,但可明显降低远期复发率,提高患者3年内生存率,值得在临床广泛应用。

Objective To observe 3 years recurrence and survival rate of no-tumor procedure applied into functional extending of the radical operation. Methods Clinical data of 60 cases of rectal cancer in our hospital from 2009 to 2013 was retrospective analyzed, they were given rectal cancer functional extending of the radical operation, and divided into the observation group and the control group（30 cases in each group） according to whether the no-tumor procedure was done or not. The operation time, blood loss, exhaust time, hospitalization time were compared between the two groups, 1 months, 3 months, 1 year, 2 years and 3 years of quality of life in two groups were analyzed by cancer patients quality of life（QOL）, and Elisa method was used to analyze the positive rate of vascular endothelial growth factor C（VEGF-C） at different time. At the same time, the recurrence rate and survival rate after 3 years of the two groups were compared. Results There was no significant difference in the operation time（53.23±3.17）min, blood loss in the operation（0.41±0.13）L, exhaust time（22.16±3.28）min, hospitalization time（19.36±4.02）d in the observation group than that in the control group（ P〈0.05）; 1 month, 3 months, 1 years after the operation, there was no significant difference in QOL scores between the observation group and the control group（ P〉0.05）, 2 years, 3 years after the operation, the QOL scores of the observation group（48.43 ±3.27）,（52.34± 4.20） were significantly higher than the control group（ P〈0.05）. 1 year, 2 years and 3 years after operation, the positive rate of VEGF-C in observation group was significantly lower than that in control group（ P〈0.05）; 3 years after the operation, the recurrence rate of observation group（6.7%） were significantly lower than the control group（16.7%）（ P〈0.05）. The 3 years survival rate of the observation group（90.0%） was significantly higher than the control group（66.7%）（ P〈0.05）. Conclusion The short-term curative effect of no-tumor procedure for rectal cancer functional extending of the radical operation is not significant, but it can significantly reduce the long-term recurrence rate, improve the survival rate of patients in 3 years, deserve the largo clinical application.