新辅助放化疗联合腹腔镜治疗低位直肠癌的临床疗效  

Clinical efficacy of neoadjuvant radiotherapy and chemotherapy combined with laparoscopy in the treatment of low rectal cancer

作　　者：孔智渊 王兵[1] 李卫平[1] KONG Zhiyuan;WANG Bing;LIWeiping(Department of General Surgery,Taicang First People's Hospital,Suzhou,Jiangsu,215400,China)

机构地区：[1]太仓市第一人民医院普外科,江苏苏州215400

出　　处：《当代医学》2022年第30期123-126,共4页Contemporary Medicine

摘　　要：目的探究新辅助放化疗联合腹腔镜治疗低位直肠癌的临床疗效。方法选取2018年1月至2020年12月太仓市第一人民医院收治的80例低位直肠癌患者作为研究对象,根据就诊顺序将其编号,根据编号单双数分为研究组和对照组,每组40例。对照组行新辅助放化疗联合开腹直肠癌根治术治疗,研究组行新辅助放化疗联合腹腔镜治疗,比较两组围手术期指标(手术时间、术中出血量、进食时间、肠道功能恢复时间及住院时间)、免疫功能(CD3^(+)、CD4^(+)、CD8^(+))水平及并发症(吻合口瘘、肺部感染、肠梗阻等)发生情况。结果研究组手术时间、进食时间、肠道功能恢复时间及住院时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05)。治疗前,两组CD3^(+)、CD4^(+)、CD8^(+)水平比较差异无统计学意义;治疗后,两组CD3^(+)、CD4^(+)、CD8^(+)水平均低于治疗前,但研究组高于对照组,差异有统计学意义(P<0.05)。研究组并发症总发生率为5.00%,低于对照组的20.00%,差异有统计学意义(P<0.05)。结论新辅助放化疗联合腹腔镜治疗低位直肠癌患者疗效确切,可改善患者免疫功能及预后,降低术后并发症发生率。Objective To investigate the clinical effect of neoadjuvant chemoradiotherapy combined with laparoscopy in patients with low rectal cancer.Methods A total of 80 patients with low rectal cancer admitted to Taicang First People's Hospital from January 2018 to December 2020 were selected as the study subjects,according to the order of treatment numbered,and they were divided into study group and control group according to the single and even numbers,with 40 cases in each group.The control group underwent neoadjuvant chemoradiotherapy combined with radical open rectal resection,and the study group underwent neoadjuvant chemoradiotherapy combined with laparoscopic treatment,the perioperative indexes(operation time,intraoperative blood loss,feeding time,intestinal function recovery time and hospital stay),immune function(CD3^(+),CD4^(+),CD8^(+)),and complications(anastomotic fistula,lung infection,intestinal obstruction,etc.)were compared between the two groups.Results The operation time,feeding time,intestinal function recovery time and hospital stay time in the study group were shorter than those in the control group,and the intraoperative blood loss was less than that in the control group,and the difference was statistically significant(P<0.05).Before treatment,there was no significant different of immune function levels between the two groups,and after treatment,the CD3^(+),CD4^(+),CD8^(+) levels in the two groups were lower than before treatment,but the study group was higher than those in the control group,and the differences were statistically significant(P<0.05).The overall complication rate in the study group was 5.00%,which was lower than 20.00%of the control group,and the difference was statistically significant(P<0.05).Conclusion Neoadjuvant chemoradiotherapy combined with laparoscopic is effective in the treatment of patients with low rectal cancer,which can improve the immune function and prognosis of patients,reduce the incidence of postoperative complications.

关 键 词：低位直肠癌 腹腔镜下直肠癌前切除术 新辅助放化疗 临床观察 

分 类 号：R735.37[医药卫生—肿瘤]