新辅助化疗联合甘露醇灌肠对局部晚期直肠癌患者R0切除率影响

Effect of neoadjuvant chemotherapy combined with mannitol enema on R0 resection rate of locally advanced rectal cancer

目的 探究新辅助化疗联合甘露醇灌肠对局部晚期直肠癌(locally advanced rectal cancer,LARC)患者R0切除率的影响。方法 筛选90例2015年6月至2019年6月于河北北方医院附属第一医院入院治疗的LARC患者,将其分为对照组(新辅助化疗+根治术)及干预组(新辅助化疗+甘露醇灌肠+根治术),观察并记录治疗前、手术前及手术后相关指标,行统计学分析。结果 干预组手术R0切除率明显高于对照组,而手术时间、术中出血量则明显低于对照组,差异具有统计学意义(P <0.05);干预组患者吻合口出血占比、肿瘤复发率明显低于对照组,差异具有统计学意义(P <0.05)。结论 新辅助化疗联合甘露醇灌肠可增加LARC手术R0切除率,降低手术时间、减少术后并发症及肿瘤复发,利于患者预后,值得临床推广。

Objective To investigate the effect of neoadjuvant chemotherapy combined with mannitol enema on R0 resection rate of locally advanced rectal cancer.Methods 90 patients with locally advanced rectal cancer admitted to the first affiliated hospital of Hebei North Hospital from June 2015 to June 2019 were selected and divided into control group,patients in the intervention group were treated with neoadjuvant chemotherapy plus radical operation,and those in the intervention group were treated with neoadjuvant chemotherapy plus 7-day mannitol enema plus radical operation,statistical analysis.Results The resection rate of R0 in the combined treatment group was significantly higher than that in the control group,while the operative time and intraoperative blood loss were significantly lower in the combined treatment group than in the control group(P<0.05)The rate of anastomotic bleeding and tumor recurrence in the combined treatment group were significantly lower than those in the control group(P<0.05).Conclusion Neoadjuvant chemotherapy combined with mannitol enema can increase the R0 resection rate,decrease the operation time,reduce the postoperative complications and tumor recurrence,and is beneficial to the prognosis of patients with locally advanced rectal cancer.