The Curative Effect Comparison Radiotherapy And Chemotherapy Laparoscopic-assisted And Open Resection For Low-rectal Cancer

Objectives:To explore the use of low colorectal cancer adjuvant chemoradiation (NeoCRT)underwent laparoscopic and open radical difference in the efficacy of surgery, todetermine the appropriate treatment plan based on the clinical treatment effect ofsurgery.Materials:Collect continuous implementation of the Cancer Hospital of Zhengzhou University,General Surgery, the same group of physicians from March2009to October2010December53cases of clinical data in low colorectal cancer underwent neoadjuvantchemotherapy and radical surgery patients. After screening based on inclusion criteriawere42cases, prospective non-randomized into the laparoscopic group28cases and14cases laparotomy group (including laparotomy5cases), compared two groups ofpatients with surgery, postoperative complications, radical tumor and local recurrence,distant metastasis rate, overall survival and disease-free survival.Results:1. two groups in gender, age, BMI, cTNM installments, ypTNM installment,previous abdominal surgery, timing of surgery, surgical procedures (AR vs APR),sphincter preservation rate, the availability of preventive colostomy, neoadjuvantchemotherapy solutions and adjuvant chemotherapy were no significant differences interms of the two groups were comparable clinical data. 2. two hours after surgery hospital stay, and no significant difference.Laparoscopic surgery group average blood loss was95(45~450) ml, significantly lessthan the laparotomy group of190(90~555) ml (P <0.001). Laparoscopic group was firstexhaust time is2(0-4) days, significantly earlier than the laparotomy group3(2-6)days (P <0.001).3. the laparoscopic group and the total incidence of complications after opensurgery group were24.5%and37.7%, the difference was not statistically significant (χ2=2.961, P=0.085); laparoscopic group postoperative ileus (1.0%vs7.5%, P=0.047),lung infection (4.9%vs22.6%, P=0.001) were significantly lower than the incidence oflaparotomy group.4. the laparoscopic group and open group3-year overall survival rates were88.1%and91.8%, the difference was not statistically significant (Log-rank value=1.283, P=0.257). Laparoscopic group and open3-year disease-free survival rates were76.9%and82.1%, the difference was not statistically significant (Log-rank value=2.107, P=0.147).5. the total number of lymph nodes and nearly two cut ends length difference wasnot statistically significant. The far end of the length of cut laparoscopic group3(2~5)cm, larger than the laparotomy group2(1~5) cm (P=0.011).6. the laparoscopic group and open group3-year cumulative rate of localrecurrence (1.4%vs8.5%, P=0.167),3-year cumulative distant metastasis rate (17.9%vs13.5%, P=0.067),3-year cumulative recurrence transfer rate (19.0%vs17.9%, P=0.164) were not statistically significant.Conclusion:In low colorectal cancer underwent neoadjuvant chemoradiotherapy laparoscopicradical surgery is safe and feasible, and can achieve and traditional open colorectalcancer radical surgery the same long-term effect.Keywords:...