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对于局部进展期低位直肠癌,目前的标准治疗方案为术前新辅助放化疗后行全直肠系膜切除(TME),该方案中,新辅助治疗在降低局部复发率及提高保肛率方面的作用已得到公认,但手术仍导致部分病人面临永久性造口及生活质量下降的风险。临床观察发现有一部分肿瘤在新辅助治疗后能达到临床完全缓解甚至病理学完全缓解,部分病人未行根治性手术也有良好的预后。因此,有学者提出对于放化疗后临床完全缓解的病例可考虑行局部切除的微创手术或仅给予密切观察的观点,近年来已有越来越多的研究探讨这种器官保留策略的可行性及有效性。
For locally advanced low rectal cancer, the current standard regimen is preoperative neoadjuvant chemoradiation followed by total mesorectal excision (TME). In this regimen, the effect of neoadjuvant therapy on reducing the local recurrence rate and improving the anal sphincter rate Has been recognized, but surgery still results in some patients at risk of permanent stoma and decreased quality of life. Clinical observation found that some neoplasms in the neoadjuvant therapy to achieve complete remission and even complete remission of the pathology, some patients without radical surgery has a good prognosis. Therefore, some scholars have put forward some suggestions on the feasibility of this organ-retention strategy in recent years for the minimally invasive surgery that can consider partial resection in cases of complete clinical remission after radiotherapy or only the close observation. And effectiveness.