Study On The Relationship Between The Degree Of Pathological Response And Postoperative Complications And Prognosis After Neoadjuvane Therapy For Rectal Cancer

Objective: The recurrence rate of complete pathological complete response after neoadjuvant therapy for local advanced rectal cancer is low,but the relationship between the degree of pathological response and postoperative complications is not clear.This study is to explore the relationship between the degree of pathological response and postoperative complications as well as the prognosis.Methods:The clinical data of 117 patients with locally advanced rectal cancer(T3 / T4 and / or N-positive)in the first people’s Hospital of Changde from December 2012 to June 2017 were retrospectively analyzed.All patients underwent laparoscopic total mesorectal excision after neoadjuvant therapy.According to the degree of postoperative pathological response,they were divided into two groups: complete pathological response group and non-PCR group.The statistical analysisof postoperative complications and survival was carried out.The result of TME was that there was no residual cancer tissue after neoadjuvant therapy(ypT0N0M0).Results: PCR were achieved in 27(23%)of the 117 patients.Postoperative complications included: incision infection,lung infection,intestinal obstruction,anastomotic leakage,anastomotic bleeding,and postoperative complications,including: infection of incisions,infection of lungs,intestinal obstruction,leakage of anastomotic stoma,bleeding of anastomotic stoma.The complications of urinary tract were analyzed.There was no significant difference in total complications between PCR group and non-PCR group.There was no significant difference in specific complications(P > 0.05).Among them,13 cases had anastomotic leakage in PCR group.Among them,7 cases of anastomotic fistula were grade A,grade B,grade B,one patient,grade C,grade A,and grade B,after drainage treatment,the patients with anastomotic leakage of grade C were treated with reoperation and fistula operation.The survival rate of PCR patients was higher than that of non-PCR patients.Conclusion:The degree of pathological response after neoadjuvant therapy was not related to the postoperative complications of laparoscopic total mesenterectomy.The survival rate of patients with PCR after neoadjuvant therapy was higher than that of non-PCR patients.