腹腔镜手术联合新辅助化疗在结直肠癌治疗中的作用

Effect of laparoscopic surgery combined with neoadjuvant chemotherapy in treatment of colorectal cancer

目的:探讨腹腔镜手术联合新辅助化疗在结直肠癌治疗中的作用。方法:将94例结直肠癌患者分为对照组与实验组,每组各47例。对照组行腹腔镜直肠癌切除术加术后化疗,实验组在此基础上加术前新辅助化疗。结果:治疗后,实验组肿瘤直径、淋巴结转移分期及保肛率等疗效明显优于对照组(P<0.05),体力状态评分、功能状态评分均优于对照组(P<0.05)。实验组生存改善率为74.47%,明显高于对照组的51.06%,差异有统计学意义(P<0.05)。实验组中位生存期、无疾病进展生存期明显长于对照组(P<0.05),但术后并发症总发生率明显低于对照组(P<0.05)。结论:腹腔镜手术联合新辅助化疗可有效改善结直肠癌患者的体力状况与功能状态,且3年生存率较高,可作为结直肠癌的理想治疗手段。

Objective： To explore the effect of laparoscopic surgery combined with neoadjuvant chemotherapy in treatment of colorectal cancer（ CRC）. Methods： A total of 94 patients with CRC were divided into experimental group（ n = 47） and control group（ n = 47） according to the willing of patients. The control group was treated with laparoscope-guided resection of rectal cancer plus postoperative chemotherapy,on which basis the experimental group was added with preoperative neoadjuvant chemotherapy. Results： After treatment,the efficacies of experimental group were all superior to those of control group in terms of tumor diameter,lymph node metastasis,anal sphincter rate as well as scores of performance status（ PS） and Karnofsky performance status（ KPS）（ P〈0. 05）. The improvement rate of survival was 74. 47% in experimental group,evidently higher than the 51. 06% in control group,and the differences were statistically significant（ P〈0. 05）. Both median survival time and progression-free survival were prominently longer,but the incidence of total postoperative complications was significantly lower in experimental group than these in control group（ P〈0. 05）. Conclusion： Laparoscopic surgery combined with neoadjuvant chemotherapy can effectively ameliorate the performance status and functional status of patients with CRC,and 3-year survival rate is higher,so it can be considered as an ideal treatment method for CRC.