中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
2012年
4期
332-335
,共4页
于志奇%张畅%高显华%左志贵%刘启志%窦维龙%徐小雯%傅传刚
于誌奇%張暢%高顯華%左誌貴%劉啟誌%竇維龍%徐小雯%傅傳剛
우지기%장창%고현화%좌지귀%류계지%두유룡%서소문%부전강
直肠肿瘤,中低位%术前放化疗%保肛手术%术后并发症%吻合口瘘
直腸腫瘤,中低位%術前放化療%保肛手術%術後併髮癥%吻閤口瘺
직장종류,중저위%술전방화료%보항수술%술후병발증%문합구루
Rectal neoplasms,mid-low%Preoperative radiochemotherapy%Sphincter preserving operation%Postoperative complications%Anastomotic leakage
目的 探讨术前放化疗对中低位直肠癌患者手术及术后并发症的影响.方法 回顾性分析2009年1月至2010年12月间第二军医大学长海医院肛肠外科收治的174例T3～T4期中低位进展期直肠癌患者的临床资料,其中接受术前放化疗者加手术治疗者81例(放化疗组),直接行手术治疗者93例(对照组).结果 术前放化疗组和对照组患者的手术切除率分别为100％(81/81)和94.6％(88/93),差异无统计学意义(P＞0.05);保肛率分别为86.4％(70/81)和73.1％(68/93),差异有统计学意义(P=0.039).两组手术时间分别为(130±15) min和(125±20) min,术中出血量分别为(100±15) ml和(95±10) ml,差异均无统计学意义(P＞0.05).两组术后并发症发生率分别为9.9％(8/81)和9.7％(9/93),差异无统计学意义(P＞0.05).结论 术前放化疗能够显著提高中低位直肠癌患者的保肛率,且并不会增加手术难度和术后并发症的发生率.
目的 探討術前放化療對中低位直腸癌患者手術及術後併髮癥的影響.方法 迴顧性分析2009年1月至2010年12月間第二軍醫大學長海醫院肛腸外科收治的174例T3～T4期中低位進展期直腸癌患者的臨床資料,其中接受術前放化療者加手術治療者81例(放化療組),直接行手術治療者93例(對照組).結果 術前放化療組和對照組患者的手術切除率分彆為100％(81/81)和94.6％(88/93),差異無統計學意義(P＞0.05);保肛率分彆為86.4％(70/81)和73.1％(68/93),差異有統計學意義(P=0.039).兩組手術時間分彆為(130±15) min和(125±20) min,術中齣血量分彆為(100±15) ml和(95±10) ml,差異均無統計學意義(P＞0.05).兩組術後併髮癥髮生率分彆為9.9％(8/81)和9.7％(9/93),差異無統計學意義(P＞0.05).結論 術前放化療能夠顯著提高中低位直腸癌患者的保肛率,且併不會增加手術難度和術後併髮癥的髮生率.
목적 탐토술전방화료대중저위직장암환자수술급술후병발증적영향.방법 회고성분석2009년1월지2010년12월간제이군의대학장해의원항장외과수치적174례T3～T4기중저위진전기직장암환자적림상자료,기중접수술전방화료자가수술치료자81례(방화료조),직접행수술치료자93례(대조조).결과 술전방화료조화대조조환자적수술절제솔분별위100％(81/81)화94.6％(88/93),차이무통계학의의(P＞0.05);보항솔분별위86.4％(70/81)화73.1％(68/93),차이유통계학의의(P=0.039).량조수술시간분별위(130±15) min화(125±20) min,술중출혈량분별위(100±15) ml화(95±10) ml,차이균무통계학의의(P＞0.05).량조술후병발증발생솔분별위9.9％(8/81)화9.7％(9/93),차이무통계학의의(P＞0.05).결론 술전방화료능구현저제고중저위직장암환자적보항솔,차병불회증가수술난도화술후병발증적발생솔.
Objective To investigate the impact of preoperative radiochemotherapy on postoperative complications in patients with mid-low rectal carcinomas.Methods Clinicopathologic data of T3 and T4 patients with mid-low rectal carcinomas in the Department of Colorectal Surgery.at the Changhai Hospital of The Second Military Medical University from January 2009 to December 2010 were analyzed retrospectively. This cohort included 81 patients treated with preoperative radiochemotherapy followed by operation (radiochemotherapy group) and 93 cases who underwent surgery alone (control group).Results Both resection rate and sphincter preservation rate were higher in the radiochemotherapy group (100％ and 86.4％ ) than those in the control group (94.6％ and 73.1％),and the difference in sphincter preservation rate was statistically significant (P=0.039).There were no significant differences in the mean operative time [(130±15) min vs.(125±20) min,P＞0.05]and mean amount of bleeding [(100±15) ml vs.(95±10) ml,P＞0.05] between the two groups.The overall incidence of postoperative complications was similar(9.9％ vs.9.7％,P＞0.05 ).Conclusions Preoperative radiochemotherapy can significantly increase sphincter preservation rate of mid-low rectal carcinomas,and does not increase the difficulty in surgical procedure and postoperative complications.
