新辅助放化疗联合腹腔镜治疗低位直肠癌(保肛)临床疗效

Application of neoadjuvant chemoradiation therapy (nCRT) combined with laparoscopy in lower rectal reserving annus surgery

目的:探讨新辅助放化疗(nCRT)联合腹腔镜手术在低位直肠癌保肛手术中的临床疗效。方法:比较nCRT联合腹腔镜直肠癌手术141例(新辅助组)和同期进行的直肠癌单纯腹腔镜手术141例(腹腔镜组)治疗效果。结果:两组在手术时间、肛门排气时间、住院时间、淋巴清扫数目、切口感染率、吻合口瘘率等方面差异无统计学意义;两组保肛率、术中出血量、远端切缘阳性率、远端切缘长度、局部复发率差异有统计学意义。结论:nCRT联合腹腔镜手术治疗低位直肠癌可以提高保肛率,降低局部复发率。

Objective： To nvestigate the clinical curative effects and advantages on neoadjuvant chemoradiation therapy （nCRT） combined with laparoscopy in lower rectal reserving annus surgery. Methods： we make a retrospective analysis of 141 patients （nCRT group） who received nCRT combined with laparoscopic rectal cancer resection and of 141 cases simply received laparoscopic rectal cancer resection at the same period in the department of colorectal surgery, Cancer Hospital of China Medical University,Liaoning Cancer Hospital＆Institute , from December 2013 to December 2015. Results： Two groups in operation time, anus exhausting time, hospital stay time, number of harvest lymph node, incision infection rate, anastomotic leakage rate are not statistic differences; Two groups of reserving anus rate （136/141 vs 125/141, P〈0.05）, intraoperating bleeding （54.8 ± 23.4ml vs 69.7 ± 29.1 mL, P〈0.05）, positive rate of distance resection margin （0/141VS 2/141, P〈0.05） ,length of distance resection margin（2.35 ± 0.70VS2.02 ± 0.46, P〈0.05）, local recurrence rate （2/141 VS 9/141, P〈0.05） are statistic differences. Conclusion： Neoadjuvant chemoradiation therapy（nCRT） combined with laparoscopic rectal resection can improve reserving anus rate and reduce local recurrence rate.