Efficacy comparison of laparoscope radical surgery after neoadjuvant chemoradiotherapy and traditional surgery alone for treatment of rectal cancer
10.3760/cma.j.issn.1006-9801.2017.11.007
- VernacularTitle:新辅助放化疗后行腹腔镜手术与单纯腹腔镜手术治疗直肠癌效果比较
- Author:
Xin LI
1
;
Xiaolei CHENG
;
Zhiguang WANG
;
Luanqiu WANG
;
Ning YANG
Author Information
1. 266042,青岛市肿瘤医院放疗一科
- Keywords:
Rectal neoplasms;
Surgical procedures,operative;
Laparoscopes;
Postoperative complications;
Neoadjuvant chemoradiotherapy
- From:
Cancer Research and Clinic
2017;29(11):749-752
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the clinical effects and safety between laparoscope radical surgery after neoadjuvant chemoradiotherapy and traditional surgery alone for treatment of rectal cancer patients. Methods A total of 122 patients with rectal cancer from January 2013 to January 2015 in Qingdao Tumor Hospital were divided into the observation group (61 cases) and the control group (61 cases) according to the different therapies. The patients in the observation group received laparoscope radical surgery after neoadjuvant chemoradiotherapy, and the patients in the control group received laparoscope radical surgery of rectal carcinoma. The operative, pathological, immunological indicators and the complications were analyzed retrospectively. Results There were no statistical differences in conversion to open laparotomy rate [6.6 % (4/61) vs. 4.9 % (3/61)], anus preservation rate [80.3 % (49/61) vs. 67.2 % (41/61)], radical rate [77.0 % (47/61) vs. 85.2 % (52/61)] in the observation group and the control group (χ2: 0.152, 2.711, 1.339 respectively, all P > 0.05). The proportion of terminal ileum in the observation group was significantly higher than that in the control group [60.3 % (38/61) vs. 21.3 % (13/61), χ 2= 21.058, P < 0.05]; the number of cleaned lymph nodes in the observation group was significantly lower than that in the control group (8±5 vs. 15±7, t= 5.834, P < 0.05). There were no significant differences between before the treatment and 7 d after surgery of the two groups in the levels of T cells, CD4+, CD8+, CD4+/CD8+and natural kill cells (P > 0.05). There were no significant differences between the observation group(24.6 %)and the control group(27.9 %)in postoperative complication rates (P> 0.05). Conclusion Laparoscope radical surgery after neoadjuvant chemoradiotherapy can reduce the number of lymph nodes dissection with low incidence rate of postoperative complications and implicit impacts on immune system,which is safe and worthy of wide application.
