术前短期放疗联合腹腔镜根治直肠癌手术临床分析
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陶凯雄

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Clinical study on laparoscopic radical operation for rectal cancer after shorttime preoperative radiotherapy
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    目的:探讨术前短期辅助放疗联合腹腔镜根治直肠癌手术的应用价值及疗效。 方法:回顾性分析近3.5年收治的Dukes B和C期直肠癌患者108例的临床资料。35例先行术前短期放疗再行腹腔镜根治手术,30例未放疗行腹腔镜根治手术,43例未放疗行开腹手术。结果:在患者术前一般情况、肿瘤大小、分期、病理类型及手术部位、手术方式等方面无明显差异情况下,放疗腹腔镜组的手术根治切除率、保肛率高于未放疗腹腔镜组和未放疗开腹组(P<0.05);术后随访局部复发率、远处转移率低于未放疗腹腔镜组和未放疗开腹组,且并发症无增加。结论:结合术前短期放疗,腹腔镜根治直肠癌具有更好的根治率和保肛率。

    Abstract:

    Objective:To explore the application and efficacy of laparoscopic radical operation for rectal cancer after preoperative shorttime radiotherapy. Methods:The clinical data of 108 patients with Dukes B and C rectal cancer were analyzed retrospectively. Thirtyfive patients underwent laparoscopic radical operation after preoperative shorttime radiotherapy, meanwhile 30 patients underwent laparoscopic radical operation, and 43 patients underwent open operation,both later groups without preoperative radiotherapy. Results:There were not significant differences in preoperative general condition, tumor size and stage, pathological type, site of operation, and mode of operation between the 3 groups. But there was a higher rate of radical resection and sphincter preservation in the laparoscopic operation plus radiotherapy group than in the other groups (P<0.05), and at postoperative followup,there were also lower rates of local recurrence and distant metastasis in the laparoscopic radiotherapy group than in the other groups,while there was no increase in complications. Conclusions:Adjuncted with preoperative shorttime radiotherapy, laparoscopic operation for rectal cancer has higher rates of resection and sphincter preservation.

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陶凯雄,王国斌,鲁发龙,陈道达,万忠诚.术前短期放疗联合腹腔镜根治直肠癌手术临床分析[J].中国普通外科杂志,2005,14(12):4-892.
DOI:10.7659/j. issn.1005-6947.2005.12.005

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  • 在线发布日期: 2005-12-25