期刊文献+

中低位进展期直肠癌长程新辅助放化疗后腹腔镜手术疗效分析 被引量:13

Evaluation of the efficacy of laparoscopic surgery in treatment of advanced mid-low rectal cancer ;following a long-term neoadjuvant chemoradiotherapy
原文传递
导出
摘要 目的探讨中低位直肠癌行新辅助放化疗后经腹腔镜手术的疗效。方法将2010年1月至2013年1月新疆医科大学附属肿瘤医院收治的74例行新辅助治疗的直肠癌患者,分为腹腔镜组(36例)及开腹组(38例)进行手术,比较两组患者的近期疗效及远期疗效。结果腹腔镜组与开腹组患者术中出血量(50 ml与100 ml)、术后排气时间(2.0 d与3.0 d)及近期并发症发生率(19.4%与42.1%)差异均有统计学意义(均P<0.05);淋巴结清扫数目(8个与10个)、手术时间(240.0 min与231.5 min)、住院时间(22.0 d与21.5 d)及术后3年无瘤生存率(53.0%与43.8%)及总生存率(70.0%与62.9%)差异均无统计学意义(均P>0.05)。结论腹腔镜手术治疗新辅助放化疗后进展期中低位直肠癌是一种安全有效的选择,与开腹手术根治性治疗远期疗效相似,创伤小、恢复快,远期疗效满意,具较好的应用前景。 Objective To explore the efficacy of laparoscopic surgery in treatment of advanced mid -low rectal cancer following a long-term neoadjuvant chemoradiotherapy.Methods Clinicopathologic and perioperative data were collected retrospectively from 74 patients with advanced mid-low rectal cancer , who received both neoadjuvant chemoradiotherapy and resections between January 2010 and January 2013 at Xinjiang tumor hospital.Routine follow-up was conducted.The safety and long-term survival of 36 patients who underwent laparoscopic resection were compared with those of 38 patients who received conventional resection.Results The laparoscopic group had less amount of blood loss during surgery (50 ml vs 100 ml, P〈0.05 ).The time needed for recovery of gastrointestinal function in the laparoscopic group was significantly shorter than that in the open surgery group ( 2.0 d vs 3.0 d, P〈0.05 ).The rate of postoperative complication was 19.4% and 42.1% ( P〈0.05 ) , respectively.In terms of the range of radical surgery and the numbers of dissected lymph nodes (8 and 10, P〉0.05), no significant difference were found in the two groups.The operation duration and hospital stay in the laparoscopic group was longer than that in the open surgery group ( 240.0 min vs 231.5 min , P〉0.05 ) ( 22.0 d vs 21.5 d , P〉0.05), but no significant difference was found between the two groups.There were no significant difference in the incidence of 3 disease-free survival rate ( 53.0% vs 43.8%, P〉0.05 ) and overall survival rate (70.0% vs 62.9%, P〉0.05 ) between two groups.Conclusion Laparoscopic surgery is a safe and feasible option for advanced mid-low rectal cancer patients who undergone the neoadjuvant chemoradiotherapy because of the similar rate of radical resection and satisfied long-term outcomes , which will have a better prospect in the future.
出处 《中华医学杂志》 CAS CSCD 北大核心 2016年第34期2709-2712,共4页 National Medical Journal of China
基金 国家自然科学基金(81560385)
关键词 直肠肿瘤 腹腔镜手术 新辅助放化疗 疗效 Rectal neoplasm Laparoscopic surgery Neoadjuvant chemoradiotherapy Curative effect
  • 相关文献

参考文献12

  • 1Sauer R, Liersch T, Merkel S, et al. Preoperative versus postoperative chemoradiotherapy for locally advanced rectal cancer: results of the German CAO/ARO/AIO-94 randomized phase Ⅲ trial after a median follow-up of 11 years [ J ]. J Clin Oncol, 2012,30 (16) : 1926-1933. DOI : 10. 1200/JCO. 2011. 40. 1836.
  • 2Sauer R, Becker H, Hohenberger W, et al. Preoperative versus postoperative chemoradiotherapy for rectal cancer [ J ]. N Engl J Med, 2004, 351 ( 17 ): 1731-1740. DOI: 10. 1056/ NEJMoa040694.
  • 3黄美近,彭慧,王辉,梁景琳,饶本强,康亮,张兴伟,汪建平.直肠癌腹腔镜与开腹手术肿瘤清除及远期疗效的随机对照试验荟萃分析[J].中华胃肠外科杂志,2011,14(8):606-610. 被引量:30
  • 4陈一林,池畔.腹腔镜和开腹直肠癌根治术的安全性及远期疗效比较[J].中华消化外科杂志,2012,11(5):462-466. 被引量:24
  • 5Ng SSM, Lee JFY, Yiu RYC, et al. Long-term oncologic outcomes of laparoscopic versus open surgery for rectal cancer: a pooled analysis of 3 randomized controlled trials [ J ]. Ann Surg, 2014, 259 ( 1 ): 139-147. DOI: 10. 1097/SLA. 0b013e31828fe119.
  • 6葛磊,王海江,赵泽亮,杨新辉,赵为民,帕尔哈提,刘林.腹腔镜中下段直肠癌根治手术的近期疗效及安全性分析[J].中华医学杂志,2012,92(2):98-101. 被引量:56
  • 7Seshadri RA, Srinivasan A, Tapkire R, et al. Laparoscopic versus open surgery for rectal cancer 'after neoadjuvant chemoradiation: a matched case-control study of short-term outcomes[ J ]. Surg Endosc, 2012, 26 ( 1 ) : 154-161. DOI: 10. 1007/s00464 -011 - 1844 -5.
  • 8Jeong SY, Park JW, Nam BH, et al. Open versus laparoseopie surgery for mid-rectal or low-rectal cancer after neoadjuvant chemoradiotherapy (COREAN trial): survival outcomes of an open-label, non-inferiority, randomised controlled trial [ J ]. Lancet Oncol, 2014, 15 ( 7 ) : 767-774. DOI: 10. 1016/S1470- 2045 ( 14 ) 70205 43.
  • 9Fleshman J, Branda M, Sargent DJ, et al. Effect of I,aparoscopic- Assisted Resection vs Open Resection of Stage Ⅱ or Ⅲ Rectal Cancer on Pathologic Outcomes: The ACOSOG Z6051 Randomized Clinical Trial [ J ]. JAMA, 2015,314 ( 13 ) : 1346- 1355. DOI: 10. 1001/jama. 2015. 10529.
  • 10Hayne D, Vaizey C J, Boulos PB, et al. Anorectal injury following pelvic radiotherapy[ J ]. Br J Surg, 2001,88 ( 8 ) : 1037-1048. DOI: 10. 1046/j. 0007-1323. 2001. 01809. x.

二级参考文献46

  • 1中下段直肠癌外科治疗规范(草案)[J].中华胃肠外科杂志,2005,8(1):88-90. 被引量:64
  • 2郑民华.腹腔镜结直肠癌手术的原则与评价[J].中华外科杂志,2005,43(17):1105-1108. 被引量:74
  • 3郑民华,马君俊.腹腔镜直肠全系膜切除术在中低位直肠癌手术中的应用现状与展望[J].中华胃肠外科杂志,2006,9(2):99-101. 被引量:53
  • 4Schiedeck TH, Fischer F, Gondeck C, et al. Laparoscopic TME: better vision, better results.'? Recent Results Cancer Res, 2005,165:148-157.
  • 5Bonjer HJ, Hop WC, Nelson H, et al. Laparoscopically assisted vs open colectomy for colon cancer: a meta-analysis. Arch Surg, 2007,142 (3) :298-303.
  • 6Kuhry E, Schwenk W, Gaupset R, et al. Long-term outcome of laparoscopic surgery for colorectal cancer: a cochrane systematic review of randomised controlled trials. Cancer Treat Rev, 2008,34(6) : 498-504.
  • 7Li M, Li JY, Zhao AL, et al. Colorectal cancer or colon and rectal cancer? Clinicopathological comparison between colonic and rectal carcinomas. Oncology, 2007,73 (1-2) : 52-57.
  • 8Anderson C, Uman G, Pigazzi A. Oncologic outcomes of laparoscopic surgery for rectal cancer: a systematic review and meta-analysis of the literature. Eur J Surg Oncol, 2008,34 (10) : 1135-1142.
  • 9Cornish JA, Tilney HS, Heriot AG, et al. A meta-analysis of quality of life for abdominoperineal excision of rectum versus anterior resection for rectal cancer. Ann Surg Oneol, 2007, 14 (7) : 2056-2068.
  • 10Gao F, Cao YF, Chen IS. Meta-analysis of short-term outcomes after laparoscopic resection for rectal cancer. Int J Colorectal Dis, 2006,21 (7) : 652-656.

共引文献98

同被引文献91

引证文献13

二级引证文献52

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部