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[目的]探讨新辅助化疗联合手术治疗直肠腹膜返折部癌的临床疗效。[方法]回顾性研究2007年1月至2009年5月146例直肠腹膜返折部癌患者的资料,146例患者分为综合治疗组(新辅助化疗+手术治疗)(n=84)和单纯手术组(n=62),比较两组临床疗效。[结果]两组手术类型、肿瘤缓解度、术中出血量、手术前后CEA值、并发症情况及术后首次排气、排便、下床活动时间均无统计学差异(P>0.05)。两组环周切缘均阴性。综合治疗组的手术时间较单纯手术组短(P<0.05);综合治疗组盆腹膜充血率较单纯手术组高(P<0.05)。综合治疗组的复发率低于单纯手术组(P<0.05)。[结论]新辅助化疗联合手术治疗直肠腹膜返折部癌具有良好的围手术期安全性,可以改善临床远期疗效,降低术后局部复发率。
[Objective] To explore the clinical effect of neoadjuvant chemotherapy combined with surgery on rectal peritoneal reentry cancer. [Methods] The data of 146 patients with rectal peritoneal recumbent carcinoma from January 2007 to May 2009 were retrospectively analyzed. 146 patients were divided into comprehensive treatment group (neoadjuvant chemotherapy plus surgery) (n = 84) and simple Surgery group (n = 62), the clinical efficacy of two groups were compared. [Results] There was no significant difference in operative type, tumor remission rate, intraoperative blood loss, CEA before and after surgery, complications and the time of the first extubation, defecation and bed ambulation after operation (P> 0.05). Two groups of circumferential margin were negative. The operation time of the integrated treatment group was shorter than that of the simple operation group (P <0.05). The rate of peritoneal hyperemia in the combined treatment group was higher than that of the simple operation group (P <0.05). The recurrence rate of the comprehensive treatment group was lower than that of the simple operation group (P <0.05). [Conclusion] Neoadjuvant chemotherapy combined with surgical treatment of rectal peritoneal reentry cancer has good perioperative safety, can improve the long-term clinical efficacy and reduce the local recurrence rate.