关键词: 新辅助放化疗, 全直肠系膜切除术, 局部进展期直肠癌, 临床疗效, 安全性

Abstract:

Objective To analyze the efficacy and safety of neoadjuvant chemoradiotherapy combined with total mesenterectomy in the treatment of locally advanced rectal cancer. Method The clinical data of 100 patients with locally advanced rectal cancer who underwent total mesenterectomy in The Fourth Affiliated Hospital of Guangxi Medical University from June 2017 to June 2020 were retrospectively analyzed, and they were divided into nCRT group (n=50) and non nCRT group (n=50) according to whether they underwent neoadjuvant chemoradiotherapy (nCRT) or not. The clinical indicators, postoperative complications and tumor stage before and after neoadjuvant chemoradiotherapy were compared between the two groups. Result The tumor stage decreased significantly after neoadjuvant radiotherapy and chemotherapy. The amount of intraoperative bleeding, operation time, postoperative hospital stay and protective stoma rate in nCRT group were higher than those in non nCRT group, and the number of lymph node dissection and anus preservation rate were lower than those in non nCRT group (P ＜ 0.05). There was no significant difference in the overall incidence of complications between nCRT group and non nCRT group (P ＞ 0.05). Conclusion Neoadjuvant chemoradiotherapy combined with total mesenterectomy can increase the protective stoma rate, prolong the operative time and increase the operative bleeding in rectal cancer patients, but can significantly reduce the tumor stage.

Key words: Neoadjuvant chemoradiotherapy, Total mesenterectomy, Locally advanced rectal cancer, Clinical efficacy, Security