术前新辅助化疗在中低位直肠癌患者中的应用价值分析

Application Value Analysis of Preoperative Neoadjuvant Chemotherapy for Mid-and Low Rectal Carcinoma Patients

为探讨术前新辅助化疗在中低位直肠癌患者中的应用效果,选取2016年6月至2017年12月我院收治的可切除的中低位直肠癌患者60例进行研究,随机分为观察组和对照组,各30例。2组患者均行腹腔镜下直肠癌手术,观察组患者术前接受辅助化疗,对照组患者不接受化疗。对比2组患者根治率、保肛率及淋巴结转移率。结果显示,观察组Dixon手术21例,Miles手术6例,Hartmman手术2例,单纯造瘘术1例,保肛率为70.00%(21/30),根治率为90.00%(27/30);对照组Dixon手术12例,Miles手术9例,Hartmman手术5例,单纯造瘘术4例,保肛率为40.00%(12/30),根治率为70.00%(21/30)。观察组保肛率及根治率均明显高于对照组,P <0.05。观察组淋巴结转移率(37.04%,10/27)明显低于对照组(66.67%,14/21),P <0.05。结果表明,术前新辅助化疗可以提高中低位直肠癌保肛率及根治率,降低淋巴结转移率,具有临床应用价值。

To investigate the application efficacy of preoperative neoadjuvant chemotherapy in mid-and low rectal carcinoma patients,60cases who were admitted in author's hospital(2016-05-2017-12)and were to be subject to mid-and low rectal carcinoma laparoscopic surgery,randomly divided into observation group (30cases,received neoadjuvant chemotherapy)and control one(30cases,did not receive this chemotherapy), and both groups received laparoscopic surgery,then both group's curative rate,anus-preserving ratio and metastatic lymph node ratio(rN)were compared.As results,in observation group 21cases subjected to Dixon procedure 馁Ch,6to Miles procedure,4to Hartmman procedure,3to simply ostomy,and anus-preserving ratio was 70.0%(21/30),curative rate 90.00%(27/30);meanwhile in control group respectively there was 12cases,9,5,4,and 40.0%(12/30),70.00%(21/30),thus the anus-preserving ratio and curative rate in observation group were significantly higher than that in control group(P <0.05),and rN so lower[37.04%(10/27)vs 66.67%(14/21),P <0.05].Results show that preoperative neoadjuvant chemotherapy can enhance anus-preserving ratio and curative rate,reduce rN,which thus has clinical application value.