直肠癌新辅助化疗后行腹腔镜辅助直肠癌超低位吻合术

近年来,对局部进展期的中低位直肠癌进行新辅助治疗已受到广泛的重视和认可。直肠癌的新辅助治疗不仅可以降低肿瘤的临床分期、控制局部复发率,而且还可以提高中低位直肠癌的保肛率。本病例特点:(1)采用XELOX新辅助化疗两周期,原发灶显著缩小,具有周期短的特点;(2)不同于同步放化疗导致的系膜水肿纤维化,手术遵循TME的间隙尚存,降低了手术难度及并发症的发生;(3)腹腔镜辅助下TME游离,在齿状线水平闭合-切断-吻合,手术流畅。

Laparoscopy-assisted surgery for ultra-low rectal cancer after neoadjuvant chemotherapy

More attention has been paid to neoadjuvant therapy in treating locally advanced middle /low rectal cancer .The therapy could degrade clinical staging and decrease local recurrence , but increase the possibility of anus-preserving procedures .The present case has the following features: ( 1 ) Neoadjuvant chemotherapy of capecitabine plus oxaliplatin (XELOX) was given for 2 courses.With a short therapeutic cycle, the volume of primary tumor decreased significantly; ( 2 ) Different from concurrent chemoradiotherapy , there was no mesenteric edema and fibrosis after 2 courses of XELOX chemotherapy , which could ensure the TME operation and decrease the difficulty in operation and the incidence rate of complications;(3) Laparoscopy-assisted TME operation and anastomosis of the colon and rectum could be performed smoothly .