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完成全腹腔切除:与初级切除的案例匹配比较.

Thijs A Burghgraef1,2, Marieke L Rutgers3, Jeroen W A Leijtens4

  • 1From the Department of Surgery, Meander Medical Centre, Amersfoort, the Netherlands.

Annals of surgery open : perspectives of surgical history, education, and clinical approaches
|September 25, 2023
PubMed
概括

针对直肠癌的完整整体隔膜切除术 (cTME) 与初级整体隔膜切除术 (pTME) 相比,显示出类似的瘤结局和发病率. 以cTME为后的局部切除是早期直肠癌的可行治疗方法.

关键词:
这是直肠癌.手术 手术 手术 手术 手术 手术 手术整体中肠直肠切除术

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科学领域:

  • 结肠直肠手术 结肠直肠手术
  • 手术瘤学手术瘤学
  • 结直肠癌的治疗方法

背景情况:

  • 早期的直肠癌可以通过局部切除来管理,从而降低了发病率和比激进手术更好的功能结果.
  • 在局部切除后的高风险特征中,完成全腹膜切除 (cTME) 是适合的,但与初级全腹膜切除 (pTME) 相比,其结果需要进行比较.

研究的目的:

  • 为了比较完成全腹腔切除术 (cTME) 与初级全腹腔切除术 (pTME) 的外科和瘤学结果.

主要方法:

  • 在荷兰11个中心 (2015-2017年) 进行了TME手术的直肠癌患者的回顾性队列研究.
  • 对cTME (n=29) 和pTME (n=58) 组进行案例匹配比较.
  • 主要结局:主要的术后发病率. 二次结果:恢复性手术率和三年瘤结果.

主要成果:

  • 在cTME和pTME之间,主要发病率 (27.6%对19.0%;P=0.28) 或腹切除率 (31.0%对32.8%;P=0.85) 没有显著差异.
  • 可比较的3年瘤结局:局部复发 (3.4%对8.6%),全身复发 (3.4%对12.1%),整体存活率 (93.1%对94.8%) 和无病存活率 (89.7%对81.0%).

结论:

  • 完成全腹腔隔膜切除 (cTME) 不会增加重大发病率,并产生类似于初级全腹腔隔膜切除 (pTME) 的瘤结果.
  • 以cTME为后的局部切除是早期直肠癌的安全有效方法,保持与pTME相似的结果.