直肠癌新辅助放化疗后过度延期根治性手术的治疗体会

摘要

目的 总结直肠癌患者新辅助放化疗后过度延期手术的治疗体会.方法 纳入2014-2016年收治的新辅助放化疗后过度延长手术介入时机(6～13个月)的7例直肠癌患者,均行根治性手术,观察手术效果及术后并发症情况.结果 3例患者行直肠前切除术(Dixon),其中2例并发吻合口漏;3例患者术中出现肠管破裂,其中1例术后并发盆腔脓肿;全组4例出现切口感染或液化;所有患者均未发生骶前静脉丛出血.结论 新辅助放化疗后过度延期手术增加了手术难度及术后并发症.%Objective To investigate the treatment experience of rectal cancer patients with excessively extended surgery after neoadjuvant chemoradiotherapy.Methods Seven cases of rectal cancer patients admitted to our hospital from 2014 to 2016 with excessively extended surgical intervention (6 to 13 months) after neoadjuvant chemoradiotherapy were included in the present study.All of the patients were treated with radical surgery,and the operation effect and postoperative complications were observed.Results Three patients underwent anterior resection of the rectum (Dixon),including 2 cases of anastomotic leakage;3 cases occurred intestinal rupture during operation,1 of them complicated with postoperative pelvic abscess;there were 4 cases complicated with incision infection or liquefaction.No presacral venous plexus hemorrhage occurred.Conclusion Excessively extended surgery after neoadjuvant chemoradiotherapy increases the difficulty of operations and the occurrence of postoperative complications in patients with rectal cancer.