新辅助化疗后中低位直肠癌的腹腔镜治疗评价

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1、新辅助化疗后中低位直肠癌的腹腔镜治疗评价［摘要］目的探讨新辅助化疗后中低位直肠癌的腹腔镜治疗效果。方法选取2014年7月〜2015年6月我院收治的100例中低位直肠癌患者，随机分为观察组和对照组各50例，所有患者均行新辅助化疗，对照组在化疗后实施开腹手术，观察组患者在化疗后实施腹腔镜治疗，对比两组患者的手术指标、术后并发症情况。结果观察组手术时间、术中出血量、肛门排气时间、住院时间分别为（209.7±44.2）min、（55.1土5.5）mL、（1.9土0.6）d、（11.4±3.2）d，与对照组的（205.4±39.6）min、（109.4±22.6）mL、（3.5±

2、0.7）d、（12.1±4.0）d相比，术中出血量、肛门排气时间均显著低于对照组（P0.05）;观察组近端切除长度为（13.4±0.6）cm，远端切除长度为（3.0±0.4）cm,对照组近端切除长度为（13.1±0.6）cm，远端切除长度为（2.8±0.3）cm，两组对比差异无统计学意义（P〉0.05）。结论中低位直肠癌患者在新辅助化疗后实施腹腔镜手术的近期疗效确切，具有创伤小、恢复快、并发症少的优势，值得在临床上推广应用。［关键词］中低位直肠癌；新辅助化疗；腹腔镜手术；近期疗效；术中出血量［中图分类号］R574.6［文献标识码］B［文章编号］1673-9701(201

3、6)09-0043-03［Abstract］ObjectiveToinvestigatetheclinicalefficacyoflaparoscopictreatmentofmiddleandlowrectalcancerafterneoadjuvantchemotherapy.Methods100patientswithmiddleandlowrectalcancerwhowereadmittedinourhospitalfromJuly2014toJune2015wereselectedasthesubjectsandrandomlyassignedintoobs

4、ervationgroupandcontrolgroupwith50patientsineachgroup.Allthepatientsreceivedneoadjuvantchemotherapyandpatientsfromobservationgroupreceivedlaparotomyafterthechemotherapywhilepatientsfromcontrolgroupreceivedlaparoscopictreatment.Operativeindexesandpostoperativecomplicationsofthepatientsfro

5、mbothgroupswerecompared.ResultsTheoperationtime，bleedingamountduringtheoperation，thetimeofanalexsufflationandhospitalizationtimeoftheobservationgroupwererespectively(209.7±44.2)min,(55.1±5.5)mL,(1.9±0.6)dand(11.4±3.2)d，whilethoseofthecontrolgroupwere(205.4±39.6)min,(109.4士22.6)mL,(3.5±0.

6、7)dand(12.1±4.0)d.Comparedwiththecontrolgroup，observationgrouphadobviouslylessbleedingamountandshortertimeofanalexsufflation(P0.05);thelengthofproximalresectionanddistalresectionoftheobservationgroupwererespectively13.4±0.6cmand(3.0±0.4)cm,whilethelengthoftheproximalresectionanddistalres

7、ectionofthecontrolgroupwererespectively(13.1±0.6)cmand(2.8±0.3)cmandtherewasnosignificantdifference(P[Keywords]Middleandlowrectalcancer；Neoadjuvantchemotherapy；Laparoscopicsurgery；Short-termefficacy；Bleedingamountduringtheoperation直肠癌是常见的消化道恶性肿瘤之一，大量的循证医学证据表明新辅助化疗能够有效降低直肠