术前新辅助化疗在中期低位直肠癌患者行腹腔镜根治术中的短期效果研究  

A study of short-term effects of preoperative neoadjuvant chemotherapy in laparoscopic radical surgery for patients with stageⅡandⅢlow rectal cancer

作　　者：孙金峰[1] 张素云[1] 李国利[1] SUN Jin-feng;ZHANG Su-yun;LI Guo-li(Department of Anorectal Surgery,Chifeng Hospital of Inner Mongolia,Chifeng 024000,China)

机构地区：[1]内蒙古赤峰市医院肛肠外科,024000

出　　处：《中国实用医药》2022年第22期31-34,共4页China Practical Medicine

基　　金：内蒙古自治区卫生健康委医疗卫生科技计划项目(项目编号:202202329)。

摘　　要：目的研究术前新辅助化疗在中期低位直肠癌患者行腹腔镜根治术中的短期效果。方法60例行腹腔镜根治术的中期低位直肠癌患者,根据治疗方案不同分为研究组和对照组,每组30例。研究组腹腔镜手术前采用新辅助mFOLFOX6方案化疗,对照组采用新辅助放化疗方案。比较两组患者肿瘤退缩情况,术中、术后情况,肛门功能,术后并发症(切口感染、吻合口瘘、肠梗阻)发生情况,淋巴结转移率、保肛率、预防性造口率、1年生存率。结果研究组肿瘤退缩率63.33%与对照组的60.00%比较,差异无统计学意义(P>0.05)。研究组术中出血量(173.11±9.24)ml少于对照组的(178.94±9.67)ml,进食时间(2.66±0.11)d早于对照组的(4.26±0.85)d,手术时间(141.01±9.31)min、住院时间(7.14±1.32)d均短于对照组的(155.63±9.44)min、(9.25±1.14)d,差异均具有统计学意义(P<0.05)。研究组远切端长度(3.11±1.02)cm、术后排气时间(2.02±0.14)d短于对照组的(5.14±1.32)cm、(3.90±0.28)d,排便次数>5次、软/稀便、排便紧迫、便失禁、使用纸尿裤、排便排气难以分清占比分别为6.67%、6.67%、40.00%、16.67%、0、16.67%,均低于对照组的60.00%、83.33%、90.00%、96.67%、86.67%、76.67%,差异均具有统计学意义(P<0.05)。研究组保肛率86.67%高于对照组的63.33%,差异具有统计学意义(P<0.05)。研究组术后并发症发生率、淋巴结转移率、预防性造口率、远期1年生存率与对照组比较,差异无统计学意义(P>0.05)。结论行腹腔镜根治术的中期低位直肠癌患者应用术前新辅助化疗的短期效果较好。Objective To study the short-term effects of preoperative neoadjuvant chemotherapy in laparoscopic radical surgery for patients with stageⅡandⅢlow rectal cancer.Methods A total of 60 patients with stageⅡandⅢlow rectal cancer undergoing laparoscopic radical surgery were divided into research group and control group according to different treatment regimens,with 30 cases in each group.The research group received mFOLFOX6 regimen as neoadjuvant chemotherapy before laparoscopic surgery,and the control group received neoadjuvant chemoradiotherapy.Both groups were compared in terms of tumor regression,intraoperative and postoperative conditions,anal function,postoperative complications(incision infection,anastomotic leakage,intestinal obstruction),lymph node metastasis rate,anus preservation rate,prophylactic stoma rate and 1-year survival rate.Results The tumor regression rate of the research group was 63.33%,and the difference was not statistically significant compared with 60.00%of the control group(P<0.05).In the research group,the intraoperative blood loss(173.11±9.24)ml was less than(178.94±9.67)ml in the control group;the eating time(2.66±0.11)d was earlier than(4.26±0.85)d in the control group;the operation time(141.01±9.31)min and hospital stay(7.14±1.32)d were shorter than(155.63±9.44)min and(9.25±1.14)d in the control group;the differences were all statistically significant(P<0.05).In the research group,the length of the distal incisal margin(3.11±1.02)cm,and the postoperative exhaust time(2.02±0.14)d were shorter than(5.14±1.32)cm and(3.90±0.28)d in the control group;the frequency of defecation>5 times,soft/loose stools,urgent defecation,fecal incontinence,use of diapers,and difficulty in distinguishing defecation and exhaust were 6.67%,6.67%,40.00%,16.67%,0,and 16.67%,which were lower than 60.00%,83.33%,90.00%,96.67%,86.67%,76.67%in the control group;the differences were all statistically significant(P<0.05).The anus preservation rate 86.67%in the research group was higher than 63.33%in

关 键 词：中期低位直肠癌 术前新辅助化疗 腹腔镜根治术 短期效果 

分 类 号：R735.37[医药卫生—肿瘤]