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真正不可避免——我们对直肠癌手术后并发症的看法。

Truly Inevitable-Our Perspective on the Complications After Surgery for Rectal Cancer.

作者信息

Vinchurkar Kumar, Togale Manoj, Maste Preeti, Chaudhary Saurin, Ahmed Imtiaz, Krishnamurthy Sapna, Bhise Rohan, Mane Jyoti, Kumbar Praveen

机构信息

Department of Surgical Oncology, KAHER's Jawaharlal Nehru Medical College, Belagavi, India.

Department of General Surgery, KAHER's Jawaharlal Nehru Medical College, Belagavi, India.

出版信息

Indian J Surg Oncol. 2025 Apr;16(2):667-675. doi: 10.1007/s13193-024-02125-3. Epub 2024 Nov 5.

Abstract

Rectal cancer is one of the most common malignancies in the GI tract. Although recent technology and treatments are available today, complications are still there. The focus of this study is to draw attention towards the important complications and their management options in rectal cancer surgeries. Retrospective study of 57 patients diagnosed and operated with rectal cancer between 2012 and 2022 using questionnaire data. 21.05% developed complications following surgery for rectal cancer including SSI, LARS, anastomosis leak, and stomal stenosis. LARS was seen in 26.31% out of the 19 patients involved in the study (LAR + ULAR) of which 80% had minor LARS scores and 20% had major LARS scores. In LARS, 80% had received long-term chemoradiotherapy in a neoadjuvant setting. The study revealed a rising trend of rectal cancer in young individuals (35.08%). Complications are an inevitable part of rectal cancer surgery even with recent technology. Use of long-course radiotherapy in neoadjuvant settings and LAR and ULAR may improve sphincter preservation with the risk of increasing incidence of low anterior resection syndrome, and anastomosis leak should be used cautiously with proper patient selection.

摘要

直肠癌是胃肠道最常见的恶性肿瘤之一。尽管如今有了最新的技术和治疗方法,但并发症仍然存在。本研究的重点是提请关注直肠癌手术中的重要并发症及其处理方法。通过问卷数据对2012年至2022年间57例诊断为直肠癌并接受手术的患者进行回顾性研究。21.05%的直肠癌患者术后出现并发症,包括手术部位感染、低位前切除综合征、吻合口漏和造口狭窄。在参与研究的19例患者(低位前切除术+超低位前切除术)中,26.31%出现低位前切除综合征,其中80%的患者低位前切除综合征评分较低,20%的患者评分较高。在低位前切除综合征患者中,80%在新辅助治疗中接受了长期放化疗。研究显示,年轻个体中直肠癌的发病率呈上升趋势(35.08%)。即使有了最新技术,并发症仍是直肠癌手术不可避免的一部分。在新辅助治疗中使用长疗程放疗以及低位前切除术和超低位前切除术可能会提高括约肌保留率,但存在增加低位前切除综合征发病率的风险,吻合口漏应在适当选择患者的情况下谨慎使用。

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