本文選題：直腸癌 + 個(gè)體化　； 參考：《首都醫(yī)科大學(xué)學(xué)報(bào)》2017年06期

【摘要】：目的探討個(gè)體化經(jīng)肛提肌外腹會陰聯(lián)合切除術(shù)(extralevator abdominoperineal excision,ELAPE)治療低位進(jìn)展期直腸癌的療效。方法 2011年6月至2015年6月,在術(shù)前磁共振成像(magnetic resonance imaging,MRI)精準(zhǔn)指導(dǎo)下,56例低位進(jìn)展期直腸癌患者接受個(gè)體化ELAPE。觀察腫瘤環(huán)周切緣、術(shù)中穿孔、術(shù)后合并癥和局部復(fù)發(fā)情況。結(jié)果術(shù)前50例(89.3%)患者接受新輔助治療。無圍術(shù)期死亡病例,術(shù)后常見合并癥包括:會陰傷口感染(9/56,16.1%)、性功能障礙(5/41,12.2%)、尿潴留(4/56,7.1%)和慢性會陰部疼痛(3/56,5.4%)。術(shù)后環(huán)周切緣(circumferential resection margin,CRM)陽性3例(5.4%),術(shù)中腸管穿孔2例(3.6%)。平均隨訪35個(gè)月(12~60個(gè)月),局部復(fù)發(fā)2例(3.6%)。結(jié)論在新輔助治療和術(shù)前MRI的精準(zhǔn)指導(dǎo)下,在不影響手術(shù)根治性的前提下,個(gè)體化ELAPE是治療低位進(jìn)展期直腸癌的安全可行技術(shù)。
[Abstract]:Objective to evaluate the efficacy of individualized excision of extralevator abdominoperineal excision (ELAPE) in the treatment of low advanced rectal cancer. Methods from June 2011 to June 2015, 56 patients with low advanced rectal cancer received individualized ELAPE under the guidance of preoperative magnetic resonance imaging (MRI). Tumor circumferential margin, intraoperative perforation, postoperative complications and local recurrence were observed. Results Neoadjuvant therapy was performed in 50 patients (89. 3%) before operation. There were no perioperative deaths, and common complications included: perineal wound infection, 9 / 56 / 16.1, sexual dysfunction, 5 / 41 / 12. 2, urine retention, 4 / 5 / 56 / 7. 1) and chronic perineum pain, 3 / 5 / 56 / 5. 4%. The circumferential resection margin was positive in 3 cases (5.4%) and intestinal perforation in 2 cases (3.6%). The average follow-up time was 35 months, 12 ~ 60 months, 2 cases of local recurrence were 3. 6%. Conclusion under the guidance of neoadjuvant therapy and preoperative MRI, individualized ELAPE is a safe and feasible technique for the treatment of low advanced rectal cancer.
【作者單位】： 首都醫(yī)科大學(xué)附屬北京朝陽醫(yī)院普通外科;
【基金】：國家高技術(shù)研究發(fā)展計(jì)劃(863計(jì)劃)(2015AA033602) 國家自然科學(xué)基金(81541101) 首都臨床特色應(yīng)用研究(Z121107001012131) 新世紀(jì)百千萬人才工程(09-911-002) 首都衛(wèi)生發(fā)展科研專項(xiàng)(2009-3109,2014-4-2033) 北京朝陽醫(yī)院1351人才培養(yǎng)計(jì)劃項(xiàng)目 首都醫(yī)科大學(xué)基礎(chǔ)-臨床研究重點(diǎn)課題(15JL03)~~
【分類號】：R735.37

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