Ju Wencui, Luo Xiaoyong, Han Baowei
Department of Radiotherapy, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, Henan Province, People's Republic of China.
Department of General Surgery, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, Henan Province, People's Republic of China.
Pak J Pharm Sci. 2016 Sep;29(5 Suppl):1817-1821.
This case-control study aimed to clarify the short- and long-term outcomes of laparoscopic surgery for rectal cancer after neoadjuvant chemo radiotherapy compared with conventional open resection. Between January 2008 and December 2014, a series of 227 patients with rectal cancer underwent radical surgery after neoadjuvant chemo radiotherapy. Age, gender, American Society of Anesthesiologists score, clinical stage, and type of resection were matched by propensity scoring and 106 patients (53 patients with laparoscopic total mesorectal excision and 53 patients with open resection) were selected for analysis. There were no significant differences in the clinicopathological features between the two groups. With regard to short-term outcomes, blood loss, postoperative analgesia and hospital stay were significantly shorter in the laparoscopy group than in the open group, whereas operative time was significantly longer in the laparoscopy group than in the open group. The overall morbidity was similar in the two groups. There were no significant differences in the 5-year overall and disease-free survival rates between the two groups. In summary, laparoscopic surgery may be both feasible and efficient compared with open resection for rectal cancer after neoadjuvant chemo radiotherapy.
本病例对照研究旨在阐明与传统开放切除术相比，新辅助化疗放疗后直肠癌腹腔镜手术的短期和长期结局。2008年1月至2014年12月期间，一系列227例直肠癌患者在新辅助化疗放疗后接受了根治性手术。通过倾向评分匹配年龄、性别、美国麻醉医师协会评分、临床分期和切除类型，选择106例患者（53例行腹腔镜全直肠系膜切除术和53例行开放切除术）进行分析。两组间临床病理特征无显著差异。关于短期结局，腹腔镜组的失血量、术后镇痛时间和住院时间明显短于开放组，而腹腔镜组的手术时间明显长于开放组。两组的总体发病率相似。两组间5年总生存率和无病生存率无显著差异。总之，与新辅助化疗放疗后直肠癌的开放切除术相比，腹腔镜手术可能既可行又有效。
