【摘要】 目的探讨分析直肠上动脉灌注化疗用于进展期直肠癌的安全性和可行性,比较其与常规根治手术的近远期临床疗效。方法回顾性分析我院2007年1月至2009年12月间进展期直肠癌根治患者,根据术中是否选择直肠上动脉灌注化疗,分为动脉灌注组(38例)和对照组(42例)。分析比较两组患者围手术期临床病理资料、术后并发症、化疗相关副作用以及远期生存和复发情况。结果两组患者年龄、性别、手术方式、Duke分期无显著性差异。两组患者术后近期并发症如吻合口瘘、切口感染、腹腔感染、术后肠道出血、尿潴留和切口脂肪液化以及远期并发症如吻合口狭窄、肠梗阻、排便功能不良无显著性差异。灌注化疗组发生Ⅲ级和Ⅳ级化疗副反应发生率高于对照组,但差异无统计学意义。尽管灌注化疗组患者术后1、3年总体生存率与对照组相比无显著差异,但灌注化疗组术后3年无复发生存率为85.8%,显著高于对照组62.1%(P<0.05)。结论进展期直肠癌根治术中行直肠上动脉灌注化疗安全、可行,并不增加围手术期并发症,化疗副反应可接受,可以降低局部复发的风险。更多还原

【Abstract】 Objective To investigate the security and feasibility of radical resection combined with intraoperative superior rectal artery infusion chemotherapy in local advanced rectal cancer , and compare the short and long-term survival outcomes between the infusion group and the traditional radical resection group. Methods From January 2007 to December 2009 , local advanced rectal cancer patients were divided into two groups , control group (42 cases) and infusion chemotherapy group (38 cases), and received traditional radical resection alone or radical resection combined with intraoperative superior rectal artery infusion chemotherapy. The perioperative clinicopatholocical data , postoperative complications,chemotherapy-related adverse events ,short-and long-term survival outcomes were compared. Results Threre were no significant differences in age , gender, surgical procedures, Duke’s stages between the two groups. No differences were found in postoperative early complications including anastomotic fistula, incision infection, intraperitoneal infection , bowel bleeding and urinary retention , and late complications including intestinal obstruction , anastomotic stricture , defecation dysfunction, between the two groups. The incidence of Grade Ⅲ and Ⅳadverse events of chemotherapy in the infusion group was higher than that in the control group , but no significant differences were found. There was no significant difference in 3-year overall survival rate between the two groups , but the 3-year recurrence-free survival rate was 85.8% in the infusion group , significantly higher than 62.1% in the control group. Conclusions Radical resection combined with intraoperative superior rectal artery infusion chemotherapy for local advanced rectal cancer if safe and feasible , does not increase postoperative complications with acceptable incidence of chemotherapy adverse events. It can reduce postoperative local recurrence.更多还原