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全方位新辅助治疗后直肠癌手术的最佳时间:手术何时变得真正具有挑战性?

Salih N Karahan¹, Mustafa Oruc, Kamil Erozkan

¹Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio.

Diseases of the colon and rectum

|August 29, 2025

概括

在整体新辅助疗法 (TNT) 后进行手术的最佳时机至关重要. 将手术推迟到24周后会增加手术难度和并发症,

科学领域:

癌症学
外科瘤学
胃肠病学

背景情况:

全方位新辅助疗法 (TNT) 越来越多地用于局部晚期的直肠癌.
在TNT后进行手术的最佳时间还不清楚.
目前的手术间隔有很大差异,有事证据表明延期增加了难度.

研究的目的:

确定TNT手术后的最佳时间窗口, 以尽量减少术后并发症.
为了确定手术难度是否超过TNT后的特定间隔.

主要方法:

一个单一的第三级护理中心的回顾性队列研究.
在TNT后接受手术的212名局部晚期直肠癌患者的分析.
主要结局:从TNT完成到手术的时间与术后并发症率之间的关联.

主要成果:

42% 的患者出现并发症,其中15% 患有Clavien- Dindo等级≥3.
在TNT治疗后≥24周进行的手术与较高的边缘阳性率,重复手术和严重并发症有关.
手术的最佳窗口似乎是在TNT后的7-12周左右.

结论:

在TNT后的手术时间显著影响了外科术后的结果.
在TNT后的24周后推迟手术与手术难度和发病率的增加有关.
需要进一步的多中心研究来验证这些发现,并制定精确的时间建议.

关键词:

疾病发病率最好的时间术后并发症手术上的困难全方位的新辅助治疗.

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