Objective To explore the clinical effect of different strategies for surgical treatment of cancer of rectum combined with neo-adjuvant chemotherapy under multi-disciplinary team. Methods From January 2007 to December 2007, the patients diagnosed definitely as rectal cancer were analyzed retrospectively, of whom accept surgery combined with neo-adjuvant chemotherapy were included. The clinical effects were studied and observed, the differences among the strategies for different surgical treatment 〔high anterior resection (HAR), low anterior resection (LAR), out-pouching with colo-anal anastomosis (OCAA), radical resection with non-saving anus (RNSA), and palliation colostomy (PCO)〕 in the multi modality therapy were compared. Results Comparing the constituent ratio of gross type of tumor in five groups, the difference between PCO group and the other 4 groups had mainly statistical significance （P＜0.05）. The difference of constituent ratio of Dukes staging had statistical significance between HAR group and OCAA group, HAR group and PCO group, LAR group and PCO group （P＜0.05）. According to the duration of operation, the persisting time of PCO group was obviously shorter than that of the other 4 groups （P＜0.05）, meanwhile, the persisting time of LAR group was shorter than that of OCAA group and RNSA group （P＜0.05）. According to the volume of ascites discovered in operation, mainly between HAR group and LAR group, between HAR group and RNSA group, the incidence of a seroperitoneum more than 200 ml in the former was less than the latter （P＜0.05）. Regarding to indexes of laboratory, CEA value in PCO group was higher than the other 4 groups, serum amyloid A value in RNSA group was higher than the other 4 groups, and the differences had statistical significances （P＜0.05）. Conclusion Mini-invasive surgery may have certain significance in clinical effect of the comprehensive treatment for advanced rectal cancer when different operative methods were combined with neo-adjuvant chemotherapy. And by the way, better clinical effect will take place when the anus-retained operation is possibly performed.
Citation：
WANG Xiaodong,LAI Weijing,XIAO Ling,QIU Meng,LI Li. Clinical Effect of Different Strategies for Surgical Treatment of Rectal Cancer Combined with Neo-Adjuvant Chemotherapy under Multi-Disciplinary Team. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2008, 15(11): 855-860. doi:
Copy
Copyright © the editorial department of CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY of West China Medical Publisher. All rights reserved
| 1. |
汪晓东， 刘春娟， 陈增蓉， 等. 多学科协作诊治模式下新辅助化疗联合手术治疗结直肠癌患者的生存质量评估 [Ｊ]. 中国普外基础与临床杂志, 2008; 15(5)∶371.
|
| 2. |
Van Cutsem E, Dicato M, Haustermans K, et al . The diagnosis and management of rectal cancer: expert discussion and recommendations derived from the 9th World Congress on Gastrointestinal Cancer, Barcelona, 2007 [Ｊ]. Ann Oncol, 2008; 19 Suppl 6∶vi1.
|
| 3. |
Titu LV, Tweedle E, Rooney PS. High tie of the inferior mesenteric artery in curative surgery for left colonic and rectal cancers: a systematic review [Ｊ]. Dig Surg, 2008; 25(2)∶148.
|
| 4. |
吕东昊, 汪晓东, 阳川华, 等. 结直肠肿瘤多学科协作诊治模式的数据库初期建设现状 [Ｊ]. 中国普外基础与临床杂, 2007; 14(6)∶713.
|
| 5. |
李 立. 结直肠癌外科应用技术的规范与创新(一) [Ｊ]. 中国普外基础与临床杂志， 2006； 13（1）∶106.
|
| 6. |
汪晓东， 冯 硕， 游小林， 等. 结直肠肿瘤多学科协作诊治模式下的随访体系建设 [Ｊ]. 中国普外基础与临床杂志, 2007; 14(6)∶709.
|
| 7. |
汪晓东, 曾天芳, 曹 霖, 等. 多学科协作诊治模式下新辅助化疗干预结直肠癌手术方案的临床研究 [Ｊ]. 中国普外基础与临床杂志， 2008； 15（6）∶451.
|
| 8. |
Charbonnet P, Gervaz P, Andres A, et al. Results of emergency Hartmann’s operation for obstructive or perforated left-sided colorectal cancer [Ｊ]. World J Surg Oncol, 2008; 6(1)∶90.
|
| 9. |
Navarro GV, Mompeán JA, Agüera QH， et al. Influence of the neo-adjuvant radiochemotherapy as a factor in the surgical treatment of rectal cancer by expert surgeon. A comparative study [Ｊ]. Int J Colorectal Dis, 2007; 22(10)∶1233.
|
| 10. |
Crozier JE, McKee RF, McArdle CS, et al. Preoperative but not postoperative systemic inflammatory response correlates with survival in colorectal cancer [Ｊ]. Br J Surg, 2007; 94(8)∶1028.
|
- 1. 汪晓东， 刘春娟， 陈增蓉， 等. 多学科协作诊治模式下新辅助化疗联合手术治疗结直肠癌患者的生存质量评估 [Ｊ]. 中国普外基础与临床杂志, 2008; 15(5)∶371.
- 2. Van Cutsem E, Dicato M, Haustermans K, et al . The diagnosis and management of rectal cancer: expert discussion and recommendations derived from the 9th World Congress on Gastrointestinal Cancer, Barcelona, 2007 [Ｊ]. Ann Oncol, 2008; 19 Suppl 6∶vi1.
- 3. Titu LV, Tweedle E, Rooney PS. High tie of the inferior mesenteric artery in curative surgery for left colonic and rectal cancers: a systematic review [Ｊ]. Dig Surg, 2008; 25(2)∶148.
- 4. 吕东昊, 汪晓东, 阳川华, 等. 结直肠肿瘤多学科协作诊治模式的数据库初期建设现状 [Ｊ]. 中国普外基础与临床杂, 2007; 14(6)∶713.
- 5. 李 立. 结直肠癌外科应用技术的规范与创新(一) [Ｊ]. 中国普外基础与临床杂志， 2006； 13（1）∶106.
- 6. 汪晓东， 冯 硕， 游小林， 等. 结直肠肿瘤多学科协作诊治模式下的随访体系建设 [Ｊ]. 中国普外基础与临床杂志, 2007; 14(6)∶709.
- 7. 汪晓东, 曾天芳, 曹 霖, 等. 多学科协作诊治模式下新辅助化疗干预结直肠癌手术方案的临床研究 [Ｊ]. 中国普外基础与临床杂志， 2008； 15（6）∶451.
- 8. Charbonnet P, Gervaz P, Andres A, et al. Results of emergency Hartmann’s operation for obstructive or perforated left-sided colorectal cancer [Ｊ]. World J Surg Oncol, 2008; 6(1)∶90.
- 9. Navarro GV, Mompeán JA, Agüera QH， et al. Influence of the neo-adjuvant radiochemotherapy as a factor in the surgical treatment of rectal cancer by expert surgeon. A comparative study [Ｊ]. Int J Colorectal Dis, 2007; 22(10)∶1233.
- 10. Crozier JE, McKee RF, McArdle CS, et al. Preoperative but not postoperative systemic inflammatory response correlates with survival in colorectal cancer [Ｊ]. Br J Surg, 2007; 94(8)∶1028.
