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題名 | Laparoscopic Total Mesorectal Excision in Locally Advanced Rectal Cancer=腹腔鏡全直腸系膜切除術治療局部侵犯性的直腸癌 |
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作者 | 黃郁純; 張伸吉; 江驊哲; 柯道維; 王輝明; 簡君儒; 郭于誠; 陳自諒; Huang, Yu-chun; Chang, Sheng-chi; Chiang, Hua-che; Ke, Tao-wei; Wang, Hwei-ming; Chien, Chun-ru; Kuo, Yu-cheng; Chen, William Tzu-liang; |
期刊 | 中華民國大腸直腸外科醫學會雜誌 |
出版日期 | 20151200 |
卷期 | 26:4 2015.12[民104.12] |
頁次 | 頁150-156 |
分類號 | 415.569 |
語文 | eng |
關鍵詞 | 直腸癌; 腹腔鏡手術; 全直腸繫膜切除; 新輔助性化學治療; 新輔助性放射治療; Rectal cancer; Laparoscopic; Total mesorectal excision; Neoadjuvant chemoradiotherapy; Chemoradiation; |
中文摘要 | 目的:評估以局部侵犯性直腸癌的病人接受新輔助性電化療後,接受腹腔鏡全直腸系膜切除術治療的結果。方法:從2006/01至2013/12,我們收集了90位局部侵犯性直腸癌病人,全部接受新輔助性電化療併腹腔鏡全直腸系膜切除術,回溯性收集相關臨床和病理資料併分析。結果:90位病人中,71.1%的病患為男性,平均年紀為59.2歲,腫瘤平均距離肛門5.2公分,平均在電療結束後59天進行手術。沒有病患因手術死亡,有1人術中轉成剖腹手術。共80%的病患可以保留肛門括約肌,術後住院天數平均為7.2天。局部復發率為3.3%,遠端轉移率為11.1%,5年整體存活率為75%,5年無腫瘤復發存活率為68%。結論:局部侵犯性直腸癌的病人接受新輔助性電化療後,以腹腔鏡全直腸系膜切除術治療是可行且適宜的,可以達到好的短期臨床結果和長期腫瘤學結果。 |
英文摘要 | Purpose. The efficacy of laparoscopic total mesorectal excision (TME) in locally advanced rectal cancer has not been demonstrated. The aim of the study is to evaluate the outcome of rectal cancer patients undergoing neoadjuvant chemoradiotherapy followed by laparoscopic TME in our hospital. Methods. Between January 2006 and December 2013, 90 locally advanced rectal cancer patients that underwent neoadjuvant chemoradiotherapy followed by laparoscopic TME were enrolled. The clinicopathological and surgical data of these patients were collected and retrospectively analyzed. Results. Of the 90 patients, 71.1% were men. The mean age of all patients was 59.2 years. The average distance of tumor location from the anal verge was 5.2 cm. The average interval between neoadjuvant chemoradiotherapy completion and surgery was 59 days. Only one patient required conversion (1.11%) to open surgery. Among 90 patients, 80% of the patients underwent sphincter-preserving operation. The 30-day mortality rate was 0%, and the mean hospital stay was 7.2 days. Three patients (3.3%) presented with anastomotic leakage. Local recurrence occurred in three patients (3.3%), whereas distant metastases occurred in 10 patients (11.1%). The 5-year overall survival rate was 75%, and the 5-year disease-free survival rate was 68%. Conclusions. Laparoscopic surgery after neoadjuvant chemoradiotherapy in patients with locally advanced rectal cancer is feasible and appropriate. It can provide good short-term clinical and oncological outcomes. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。