术前短期放疗联合腹腔镜根治直肠癌手术临床分析  

Clinical study on laparoscopic radical operation for rectal cancer after short-time preoperative radiotherapy

作　　者：陶凯雄[1] 王国斌[2] 鲁发龙[1] 陈道达[2] 万忠诚[3] 

机构地区：[1]华中科技大学同济医学院附属协和医院腹腔镜外科中心,湖北武汉430022 [2]华中科技大学同济医学院附属协和医院胃肠外科中心,湖北武汉430022 [3]华中科技大学同济医学院附属协和医院肿瘤放疗中心,湖北武汉430022

出　　处：《中国普通外科杂志》2005年第12期890-892,共3页China Journal of General Surgery

摘　　要：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1 0 8例的临床资料。3 5例先行术前短期放疗再行腹腔镜根治手术,3 0例未放疗行腹腔镜根治手术,4 3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<0.0 5);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。Objective To explore the application and efficacy of laparoscopic radical operation for rectal cancer after preoperative short-tiine radiotherapy. Methods The clinical data of 108 patients with Dukes B and C rectal cancer were analyzed retrospectively. Thlrty-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 radieal resection and sphincter preservation in the laparoscopic operation plus radiotherapy group than in the other groups （ P 〈0. 05 ） , and at postoperative foltowup, there were also lower rates of local recurrence and distant metastasis in the laparoscopie 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.

关 键 词：直肠肿瘤/治疗 腹腔镜术 

分 类 号：R735.37[医药卫生—肿瘤] R572[医药卫生—临床医学]