新辅助化疗联合手术治疗直肠腹膜返折部癌84例  

Neoadjuvant Chemotherapy Combined with Surgery for 84 Cases with Rectal Cancer Peritoneal Reflection Type

作　　者：秦昌龙[1] 曾天芳[1] 唐之韵[1] 武佐威[1] 王彬[1] 汪晓东[1,2] 李立[1,2] 

机构地区：[1]四川大学华西临床医学院/华西医院MCQ团队,四川成都610041 [2]四川大学华西医院胃肠外科中心,四川成都610041

出　　处：《肿瘤学杂志》2011年第5期366-370,共5页Journal of Chinese Oncology

基　　金：四川省卫生厅科研课题(080278)

摘　　要：[目的]探讨新辅助化疗联合手术治疗直肠腹膜返折部癌的临床疗效。[方法]回顾性研究2007年1月至2009年5月146例直肠腹膜返折部癌患者的资料,146例患者分为综合治疗组(新辅助化疗+手术治疗)(n=84)和单纯手术组(n=62),比较两组临床疗效。[结果]两组手术类型、肿瘤缓解度、术中出血量、手术前后CEA值、并发症情况及术后首次排气、排便、下床活动时间均无统计学差异(P>0.05)。两组环周切缘均阴性。综合治疗组的手术时间较单纯手术组短(P<0.05);综合治疗组盆腹膜充血率较单纯手术组高(P<0.05)。综合治疗组的复发率低于单纯手术组(P<0.05)。[结论]新辅助化疗联合手术治疗直肠腹膜返折部癌具有良好的围手术期安全性,可以改善临床远期疗效,降低术后局部复发率。[Purpose] To investigate the clinical response of neoadjuvant chemotherapy combined with surgery for rectal cancer peritoneal reflection type.[Methods] From January 2007 to May 2009,the date of 146 cases with rectal cancer peritoneal reflection type was analyzed retrospectively.The patients were divided into combined therapy group（neoadjuvant chemotherapy＋ surgery）（n=84） and surgery alone group（n=62）.The response between the two groups was compared.[Results] There was no significant difference in type of surgery,degree of tumor response,intraoperative blood loss,CEA values before and after surgery,complications and first exhaust time,first defecation time and active time between the 2 groups（P0.05）.Circumferential resection margin was negative in both groups.The operation time in combined therapy group was shorter than that in surgery alone group（P0.05）.The rate of peritoneal hyperaemia and local recurrence in combined therapy group was higher than that in surgery alone group（P0.05）.[Conclusion] Neoadjuvant chemotherapy combined with surgery for rectal cancer peritoneal reflection type is safe in perioperative period,and may improve the long-term response and decrease local recurrence rate.

关 键 词：新辅助化疗 直肠肿瘤 腹膜返折部 

分 类 号：R735.31[医药卫生—肿瘤]