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在超低直肠癌中进行腹腔镜间切除后的长期结果和失败模式

Wen-Long Qiu¹, Xiao-Lin Wang², Jun-Guang Liu³

¹Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.

World journal of gastrointestinal surgery

|July 5, 2023

概括

laparoscopic intersphincteric resection (LsISR) 对于超低性直肠癌是安全的. 这种方法可以在超低性直肠癌中使用. 阳性淋巴结和差异化是复发和转移的关键风险因素,建议量身定制的治疗策略.

科学领域:

手术瘤学手术瘤学
胃肠道手术胃肠道手术
结直肠癌的治疗方法

背景情况:

间切除术 (ISR) 是用于超低直肠癌的门保护手术,是腹腔经管切除 (APR) 的替代方案.
在ISR之后,故障模式和局部复发和远程转移的风险因素需要进一步调查.

研究的目的:

评估腹腔镜ISR (LsISR) 的长期结果和失败模式在患有超低直肠癌的患者中.

主要方法:

在2012年至2020年期间接受LsISR治疗的368名患者的回顾性评估.
使用奇平方或皮尔森测试进行相关性分析.
对总生存 (OS),局部无复发生存 (LRFS) 和远程无转移生存 (DMFS) 的预后因素进行考克斯回归分析.

主要成果:

三年后的OS,LRFS和DMFS的比率分别为91.3%,97.1%和90.1%.
阳性淋巴结状况和差差分化与局部复发的增加有关.
阳性淋巴结状况和 (y) pT3阶段是远程转移的独立预后因素.

结论:

对于超低水平的直肠癌,LsISR在瘤学上是安全的.
不良分化, (y) pT3阶段和淋巴结转移是治疗失败的独立风险因素.
患有这些风险因素的患者需要优化新辅助疗法;对于高风险的局部复发病例,可以考虑延长切除 (例如,APR).

关键词:

脊髓间切除 - - 脊髓间切除.laparoscopic 手术拉巴洛斯科普手术是用眼镜进行的手术.这是直肠癌.复发情况复发情况风险因素风险因素

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