目的探讨低位局部进展期直肠癌新辅助放化疗后完全缓解病例的进一步治疗方案及效果。 方法回顾性分析江苏省中医院肿瘤外科2008年1月至2010年5月期间行新辅助放化疗后初步判断达到病理完全缓解（pCR）的14例低位局部进展期直肠癌患者的临床资料。 结果14例患者中接受手术者10例，术后真正达到pCR者5例；术后2例复发或转移，其中死亡1例，1例带瘤生存，余8例患者均无瘤生存。未行手术的4例患者中，有3例复发或转移，其中2例死亡，1例带瘤生存；余1例无瘤生存。4例未行手术病例中CEA水平正常者（<5 μg/L）2例（1例复发或转移），CEA升高的2例均发生转移；10例手术病例中CEA水平正常者6例（均无瘤生存，4例真正达到pCR），升高者4例（1例真正达到pCR，2例复发或转移）。 结论接受新辅助放化疗后初步判断达到pCR的病例，尤其是CEA值高于正常者，应接受规范的全直肠系膜切除（TME）手术以达到根治的目的。
ObjectiveTo investigate the diagnosis, treatment, and prognosis of the postoperative intestinal obstruction of gastrointestinal cancer. MethodThe clinical data of 58 patients with postoperative intestinal obstruction of gastrointestinal cancer from January 2011 to January 2013 were analyzed retrospectively. ResultsIn 58 patients with postoperative intestinal obstruction, there were 46 cases of incomplete intestinal obstruction, 12 cases of complete obstruction. Seventeen cases were treated conservatively and 41 cases were accepted laparotomy. The surgical exploration found that there were 4 cases of strangulated abdominal internal hernia, 4 cases of volvulus, 1 case of stercoral obstruction, 2 cases of intussusception, 9 cases of adhesive intestinal obstruction, and 21 cases of tumor recurrence. There were 32 patients with high tumor markers before laparotomy, including 19 cases of tumor recurrence. Fourteen cases had no obvious tumor lesions detected by PET-CT, but recurrence and metastasis were found by surgical exploration. ConclusionsThe recurrent postoperative intestinal obstruction of gastrointestinal cancer mostly means recurrence and metastasis, with poor prognosis. Early laparotomy may improve the prognosis and the quality of life, elevated tumor markers have some links with tumor recurrence and PET-CT is not sensitive for multiple nodular metastases.