中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2010年
5期
353-356
,共4页
夏泽锋%袁野%陶凯雄%韩高雄%帅晓明%蔡开琳%王继亮%杜寒松%邓美洲%王国斌
夏澤鋒%袁野%陶凱雄%韓高雄%帥曉明%蔡開琳%王繼亮%杜寒鬆%鄧美洲%王國斌
하택봉%원야%도개웅%한고웅%수효명%채개림%왕계량%두한송%산미주%왕국빈
结直肠肿瘤%化学疗法,肿瘤,局部灌注%组织学
結直腸腫瘤%化學療法,腫瘤,跼部灌註%組織學
결직장종류%화학요법,종류,국부관주%조직학
Colorectal neoplasms%Chemotherapy,cancer,regional perfusion%Histology
目的 评估腹腔镜结直肠癌手术联合术前区域动脉灌注化疗的组织学疗效及其临床应用价值.方法 对23例结、直肠癌患者于术前应用Seldinger技术行区域动脉造影并行选择性动脉灌注化疗,针对直肠癌以及肝转移的患者同时行碘油栓塞,1-11 d后行腹腔镜手术,标本行病理组织学检测.参照化疗组织学疗效评定标准评级,分析其与肿瘤分化程度、TNM分期之间的联系,比较术前区域动脉灌注化疗与术前区域动脉灌注化疗联合栓塞的组织学疗效差异.应用χ2检验组内差异.结果 经术前动脉灌注化疗的23例患者其肿瘤组织学疗效0级2例,Ⅰ级7例,Ⅱ级10例,Ⅲ级4例,总有效率为91%(21/23),在15例有淋巴结转移的患者中有效率为87%(13/15).肿瘤分化程度、TNM分期与组织学疗效无明显相关性.术前介入化疗联合栓塞较单独应用化疗疗效有显著性优势.结论 对不同分化程度、不同TNM分期的结直肠癌患者,术前选择性区域动脉灌注化疗均有良好的组织学疗效,直肠癌患者联合栓塞治疗可进一步提高疗效.
目的 評估腹腔鏡結直腸癌手術聯閤術前區域動脈灌註化療的組織學療效及其臨床應用價值.方法 對23例結、直腸癌患者于術前應用Seldinger技術行區域動脈造影併行選擇性動脈灌註化療,針對直腸癌以及肝轉移的患者同時行碘油栓塞,1-11 d後行腹腔鏡手術,標本行病理組織學檢測.參照化療組織學療效評定標準評級,分析其與腫瘤分化程度、TNM分期之間的聯繫,比較術前區域動脈灌註化療與術前區域動脈灌註化療聯閤栓塞的組織學療效差異.應用χ2檢驗組內差異.結果 經術前動脈灌註化療的23例患者其腫瘤組織學療效0級2例,Ⅰ級7例,Ⅱ級10例,Ⅲ級4例,總有效率為91%(21/23),在15例有淋巴結轉移的患者中有效率為87%(13/15).腫瘤分化程度、TNM分期與組織學療效無明顯相關性.術前介入化療聯閤栓塞較單獨應用化療療效有顯著性優勢.結論 對不同分化程度、不同TNM分期的結直腸癌患者,術前選擇性區域動脈灌註化療均有良好的組織學療效,直腸癌患者聯閤栓塞治療可進一步提高療效.
목적 평고복강경결직장암수술연합술전구역동맥관주화료적조직학료효급기림상응용개치.방법 대23례결、직장암환자우술전응용Seldinger기술행구역동맥조영병행선택성동맥관주화료,침대직장암이급간전이적환자동시행전유전새,1-11 d후행복강경수술,표본행병리조직학검측.삼조화료조직학료효평정표준평급,분석기여종류분화정도、TNM분기지간적련계,비교술전구역동맥관주화료여술전구역동맥관주화료연합전새적조직학료효차이.응용χ2검험조내차이.결과 경술전동맥관주화료적23례환자기종류조직학료효0급2례,Ⅰ급7례,Ⅱ급10례,Ⅲ급4례,총유효솔위91%(21/23),재15례유림파결전이적환자중유효솔위87%(13/15).종류분화정도、TNM분기여조직학료효무명현상관성.술전개입화료연합전새교단독응용화료료효유현저성우세.결론 대불동분화정도、불동TNM분기적결직장암환자,술전선택성구역동맥관주화료균유량호적조직학료효,직장암환자연합전새치료가진일보제고료효.
Objective To evaluate the histological response and the clinical value in laparescopic colorectal surgery combined with preoperative regional intra-arterial chemotherapy(PRAC). Methods In cases of rectal cancer and fiver metastases selective regional intra-arterial chemotherapy and iodinated oil embolism was carried out in 23 cases of colorectal carcinoma. After 1 to 11 days laparoseopic radical resection was done, specimens were sent for histopathological examination. We analyzed the correlation between tumor differentiation and TNM stage, compared the effect of PRAC with PRAC + embolism by the criteria of histological response of chemotherapy. χ2-test was used to compare interclass correlation.Results The histological effect in the 23 cases of PRAC level 0 was in 2 cases, level Ⅰ in 7 cases, level Ⅱ in 10 cases, and level Ⅲ in 2 cases. The overall effective rate was 91% (21/23). In the 15 cases with lymph node metastases, the effective rate was 87% (13/15). There was no significant statistic correlation between tumor differentiation or TNM stage and histological response. PRAC associated embolism had a better histological response compared to PRAC alone. Conclusions Preoperative regional intra-arterial chemotherapy had marked therapeutic effect on histological response to the colorectal carcinoma patients of various tumor differentiations and TNM stage, especially combining with the embolism to rectal cancer could improve the efficacy.
