资源描述：
《配合术前行放化疗直肠系膜全切除保肛治疗中低位直肠癌疗效观察》由会员上传分享，免费在线阅读，更多相关内容在学术论文-天天文库。
1、配合术前行放化疗直肠系膜全切除保肛治疗中低位直肠癌疗效观察【摘要】目的探讨配合术前行放化疗直肠系膜全切除保肛治疗中低位直肠癌的可行性。方法纳入中低位直肠癌且肿瘤下缘距肛缘>5cm的患者为观察对象，行直肠系膜全切除保肛治疗。术前行放化疗，新辅助放化疗后休息6~8周进行手术。针对不同病情分别采取低位前切除术，超低位前切除术(癌肿距肛缘5cm以内)。所有病例均术后定期化疗。结果全组病例无术中死亡。术后半年，20例排便功能基本恢复正常，为64.5%，8例排便功能较差，为25.8%，3例排便功能差，为9.7%(主要表现为无便意或大便不能控制)。术后随访1~6年，术后1年内吻合口狭窄2例
2、。5年生存17例占54.8%，局部复发率15.4%。结论保肛手术在完善患者病情的术前评估，严格合理地选择手术适应证，配合术前行放化疗实施全直肠系膜切除术，中低位直肠癌保肛手术疗效确切。�【关键词】全直肠系膜切除术；中低位直肠癌；保肛手术；放化疗Linewithpreoperativeradiotherapyandchemotherapytotalmesorectalexcisionanustreatmentoflowrectalcancer8LIUDali,LIUQing-feng,TONGTao.SurgicalDepartment,ChangtuCounty2zdHosp
3、ital,TielingCity,Liaoning112512,China【Abstract】ObjectiveDiscussionwithpreoperativeradiotherapyandchemotherapylinestotalmesorectalexcisionanustreatmentofthefeasibilityoflowrectalcancer.MethodsIncorporatedinthelowrectalcancerandthetumorfromtheanalmarginoftheloweredgeof>5cmpatientsforobservati
4、onobject,thetotalmesorectalexcisionanustreatment.Linepreoperativeradiotherapyandchemotherapy,radiotherapyandchemotherapyafterneoadjuvantrest6to8weeksforanoperation.Takenseparatelyfordifferentconditionsoflowanteriorresection,ultra-lowanteriorresection(tumorlessthan5cmfromtheanalmargin).Allpa
5、tientsunderwentpostoperativechemotherapyregularly.ResultsAllpatientsdiedwithoutsurgery.Aftersixmonths,20casesofbowelfunctionreturnedtonormal,and64.5%,8casesofpoorbowelfunction,was25.8%,threecasesof8defecationbadfor9.7percent(mainlyfornon-performancewillbeItalianorstoolcontrol).Postoperative
6、follow-up1~6years,oneyearaftertwocasesofanastomoticstenosis.5-yearsurvivalof17casesaccountedfor54.8%,15.4%localrecurrencerate.ConclusionSphincter-savingsurgerytoimprovepatientsatpreoperativeassessment,strictlyrationalselectionofoperativeindication,coupledwithpre-operativeradiotherapyandchem
7、otherapylineimplementationoftotalmesorectalexcision,inlowrectalcancersurgeryexactanus.�【Keywords】Totalmesorectalexcision;Inlowrectalcancer;Anussurgery;Radiotherapyandchemotherapy8直肠癌患者中约有75%系中低位癌，按传统手术原则，行腹会阴联合根治术，其手术创伤大、术后生活质量明显下降(尤其是对于粪便改道)，而给患者带来生活质量上
