| Objective:Through effective statistical calculation, analysis and application of laparoscopicsurgery and preoperative neoadjuvant therapy in low rectal cancer confirmed the roleof anus preservation operation, discusses different ways of treatment of tumor fromanal edge distance requirements.Methods:Selected from July2012to July2013in liaoning province tumor hospital e.surgery within the same treatment team, and the edge of tumor from anal edge6cmof less than76cases of patients with low rectal cancer, all patients were selectedshould line of tumor markers, the anus dre, electronic colorectal colonoscopy andpathology biopsy diagnosis of colorectal cancer, pelvic magnetic resonance (NMR) orendoscopic ultrasonography examination, determine the rectum infiltration depth andsurrounding lymph node metastasis from the primary lesion and line the chest andabdominal CT and other related to exclude liver, lungs and other tissues and organs ofdistant metastasis. After diagnosis clear organization by radiotherapy, and oncology,surgeons to participate in the consultation to accord with a standard line and agreesthat the patients with preoperative neoadjuvant therapy, formulate preoperativeradiotherapy and at the same time it was oral chemotherapy treatment plan. Do notconform to the patients and not direct line TME radical surgery. After the preoperative neoadjuvant therapy, to evaluate treatment effect, and the rest4~6weeks after TMEradical surgery. Treatment process should be recorded in the patient’s gender, age,distance of tumor from anal edge, tumor size, preoperative staging, whetherpreoperative neoadjuvant therapy, surgical approach. And apply effective statisticalmethods for analysis.Results:The research results show that (1) line of laparoscopic surgery for37patientswith anal, failed to protect patients with anal for4cases; Line open operation for24patients with anal, failed to protect patients with anal for11cases, χ2=5.59, P <0.05,the influence of two kinds of preserved anus surgical operation success rate wasstatistically difference.(2) bartender anus for37cases of the patients withlaparoscopic group, the tumor from the anal edge distance of4.43±0.93cm; Opengroup number of24patients with confirmed anal, tumor of anal edge distance of5.20±0.91cm, t=3.18, P <0.01, two operation modes of tumor from anal edge distancerequirements of statistically significant.(3) after preoperative neoadjuvant therapy for26patients with anal, number of2patients with failed to protect anal; No preoperativeneoadjuvant therapy of patients with anal number of35patients, failed to protect analin13cases, χ2=4.43, P <0.05, two different treatment effect of preserved anussurgery success rate was statistically difference.(4) lines of neoadjuvant therapygroup insurance anus for26patients, the patients with tumor of anal edge distance of3.96±0.78cm; Without neoadjuvant therapy group insurance anus for35cases, thepatients with tumor of anal edge distance of5.31±0.70cm, t=7.03, P <0.01, twodifferent treatment distance of tumor from anal margin requirements was statisticallydifference.Conclusion:The application of laparoscopic rectal cancer low anus preservation operationsuccess rate higher than that of open operation. Laparoscopic anal surgery of tumorfrom anal edge distance required less than laparotomy. Application of preoperativeneoadjuvant therapy for patients with low rectal cancer confirmed anal surgerysuccess rate higher than that of patients who were not used preoperative neoadjuvant therapy. The patients with low rectal cancer tumor location should be preoperativeneoadjuvant therapy, which increases the success rate of anal surgery. Before surgeryin patients with low rectal cancer should carry on the accurate evaluation of theclinical stages, for different patients with different stages of treatment, in order toachieve effect a radical cure cancer while sparing the anus. |
