摘要
目的探讨新辅助治疗后低位直肠癌患者行不同术式治疗的疗效及安全性。方法回顾性分析2019年5月至2023年6月商丘市第一人民医院收治的80例低位直肠癌患者的临床资料。所有患者均进行新辅助治疗达到几乎完全缓解(almost-cCR)后行手术治疗,根据所行手术方式不同分为A组42例(行局部切除术)和B组38例(行根治性切除术)。比较两组患者的术后情况、术后并发症、术后6个月和术后1年的预后以及术前、术后3个月的生存质量测定量表简表(WHOQOL-BREF)评分。结果A组患者的手术时间、住院时间、术中出血量分别为(1.74±0.41)h、(2.05±0.58)d、(94.89±14.41)mL,明显短(少)于B组的(2.05±0.58)h、(8.75±1.23)d、(115.21±15.33)mL,差异均有统计学意义(P<0.05);A组患者术后并发症发生率为7.14%,明显低于B组的23.68%,差异有统计学意义(P<0.05);术后6个月和1年,两组患者的复发率和死亡率比较差异均无统计学意义(P>0.05);术后3个月,A组患者的WHOQOL-BREF中的生理领域、心理领域、社会领域、环境领域评分分别为(15.84±2.20)分、(14.09±1.49)分、(13.06±1.30)分、(15.35±1.26)分,明显高于B组的(13.96±1.85)分、(12.42±1.72)分、(11.95±1.83)分、(14.18±2.02)分,差异均有统计学意义(P<0.05)。结论低位直肠癌患者新辅助治疗达到almost-cCR后,与根治性切除术比较,局部切除术可获得更好的手术治疗效果以及生存质量,术后并发症发生风险较低,预后较好。
Objective To observe the effects and safety of different surgical procedures for low rectal cancer patients after neoadjuvant therapy.Methods Retrospective analysis of the clinical data of 80 patients with low rectal cancer who were admitted to the First People's Hospital of Shangqiu from May 2019 to June 2023.All patients underwent surgical treatment after achieving almost clinical complete response(almost-cCR)with neoadjuvant therapy.According to different surgical procedures,they were divided into 42 cases of group A(local resection)and 38 cases of group B(radical resection).The postoperative conditions,complications,prognosis at 6 months and 1 year after surgery,and the World Health Organization Quality of Life-BREF(WHOQOL-BREF)scores before surgery and 3 months after surgery were compared between the two groups.Results The operation time,hospital stay,and intraoperative blood loss in group A were(1.74±0.41)h,(2.05±0.58)d,and(94.89±14.41)mL,respectively,which were significantly shorter(less)than(2.05±0.58)h,(8.75±1.23)d,and(115.21±15.33)mL in group B(P<0.05).The incidence of postoperative complications in group A was 7.14%,which was significantly lower than 23.68%in group B(P<0.05).There were no statistically significant differences in recurrence rates and mortality rates between the two groups at 6 months and 1 year after surgery(P>0.05).Three months after surgery,the WHOQOL-BREF scores for physical,psychological,social,and environmental domains in group A were(15.84±2.20)points,(14.09±1.49)points,(13.06±1.30)points,and(15.35±1.26)points,respectively,which were significantly higher than(13.96±1.85)points,(12.42±1.72)points,(11.95±1.83)points,and(14.18±2.02)points in group B(P<0.05).Conclusion For patients with low rectal cancer who achieve almost-cCR after neoadjuvant therapy,local excision results in better surgical outcomes and quality of life compared to radical resection,with a lower risk of postoperative complications and a favorable prognosis.
作者
崔广宾
刘成远
穆速
马广纵
李俊江
CUI Guang-bin;LIU Cheng-yuan;MU Su;MA Guang-zong;LI Jun-jiang(Third Department of Gastrointestinal,Hepatobiliary and Biliary Surgery,the First People's Hospital of Shangqiu,Shangqiu 476000,Henan,CHINA)
出处
《海南医学》
2025年第6期780-784,共5页
Hainan Medical Journal
基金
2022年河南省商丘市第一人民医院科研项目(编号:YJ20220112)。
