Objective To discuss the influence of the progress and result in rectal cancer operation through application of neo-adjuvant chemotherapy in multi-disciplinary team (MDT). Methods The patients treated in MDT model and non-MDT model between June to September 2007 were respectively analyzed, and the index about pathologic change, histologic transform and operative result between the two groups were compared.Results In the index of pathologic change, the incidence of abdominal adherence (13.5%, 7/52), ascites (7.7%, 4/52) and latent malignant intestinal obstruction (5.8%, 3/52) in MDT model group were obviously less than non-MDT model group (P=0.000). In the index of histologic transform, texture of mesentery in MDT model group was more fragile than non-MDT model group (P=0.000). The incidence of edema of pelvic tissues in MDT model group were more than non-MDT model group (P=0.000). However, the differences between the incidence of edema of pelvic peritoneum and adherence of mesorectum in two groups were insignificant (P gt;0.05). In the index of operative results, the operative duration and intra-operative bleeding in MDT model group were less than non-MDT model group (P=0.000). And the protection of pelvic autonomic nerve in MDT model group was better than non-MDT model group (P=0.000). Meanwhile, accuracy rate in prediction of radical resection with anus-preserving in both groups were in high level (92.3% vs 76.2%). Conclusion Neo-adjuvant chemotherapy has certain influence in rectal cancer operation, but the successful operations are performed by standard and correct procedures. Therefore, optimizing combined therapy in MDT model and constructing preoperative evaluation system with neo-adjuvant chemotherapy, would be the next important focus.
Citation：
WANG Xiaodong,LI Yalun,QIU Meng,LUO Deyun,LI Li.. Influence of Neo-Adjuvant Chemotherapy in Rectal Cancer Operation Within Multi-Disciplinary Team. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2008, 15(2): 136-139. doi:
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Copyright © the editorial department of CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY of West China Medical Publisher. All rights reserved
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- 3. Czito BG,Willett CG,Bendell JC.Combined-modality therapy for rectal cancer:future prospects[J].Clin Colorectal Cancer,2007; 6(9):625.
- 4. Sanghera P,Ho K,Muscroft T,et al.Neoadjuvant chemotherapy enables R0 resection of locally advanced rectal cancer in a patient with a previously irradiated pelvis[J].Br J Radiol,2007; 80(956):e170.
- 5. Rezvani M,Franko J,Fassler SA,et al.Outcomes in patients treated by laparoscopic resection of rectal carcinoma after neoadjuvant therapy for rectal cancer[J].JSLS,2007; 11(2):204.
- 6. Niederbuber JE.Neoadjuvant therapy[J].Ann Surg,2003; 229(3):303.
- 7. Theodoropoulos G,Wise WE,Padmanabhan A,et al.T-level downstaging and complete pathologic response after preoperative chemoradiation for advanced rectal cancer result in decreased recurrence and improved disease-free survival[J].Dis Colon Rectum,2002; 45(7):895.
- 8. 李立.结直肠癌外科应用技术的规范与创新(一)～(十二)[J].中国普外基础与临床杂志,2006～2007; 13(1～6):106,222,336,461,597,719; 14(1～6):96,216,350,481,592,716.
- 9. De Paoli A,Innocente R,Buonadonna A,et al.Neoadjuvant therapy of rectal cancer new treatment perspectives[J].Tumori,2004; 90(4):373.
