新辅助放化疗热疗联合腹腔镜手术治疗进展期直肠癌的临床疗效

目的探讨新辅助放化疗、热疗联合腹腔镜手术治疗进展期直肠癌的临床疗效。方法收集2009年1月至2010年1月收治的86例进展期直肠癌患者，随机分为观察组和对照组，每组43例。观察组患者给予新辅助放化疗、热疗联合腹腔镜手术治疗；对照组患者给予新辅助放化疗联合腹腔镜手术治疗。观察两组患者肿瘤缓解情况、手术相关指标和远期预后情况。结果观察组患者治疗总有效率为53．5％，TNMⅠ期3例、Ⅱ期11例、Ⅲ期29例，均优于对照组；观察组患者的手术时间、手术中出血量、手术后引流量、排气时间、下床时间以及发生吻合口瘘、局部复发、远处转移的情况均明显少于对照组；3年存活率（81．4％）明显高于对照组（55．8％）。结论新辅助放化疗、热疗联合腹腔镜手术治疗能够在手术前降低肿瘤分期、减小手术创伤、促进手术后恢复、改善预后，具有积极的临床价值。

Effect of neoadjuvant chemoradiotherapy,hyperthermia combined with laparoscopic operation on advanced rectal cancer

Objective To study the clinical effect of neoadjuvant chemoradiotherapy, hyperthermia combined with laparoscopic operation on advanced rectal cancer. Methods In total of 86 patients were enrolled in this study, these patients with advanced rectal cancer were randomly divided into observation and control group. Then tumor response, operation related parameters and long-term prognosis were analyzed. Results Overall response rate of observed group was 53.5% and 3 cases with TNM stage Ⅰ, 11 cases with stage Ⅱ, 29 cases with stage Ⅲ of observation group were better than control group; operation time, bleeding volume, postoperative drainage, exhaust time, bed time and the occurrence of anastomotic fistula, local recurrence, distant transfer cases of observation were significantly less than control group ; 3 year survival rate （81.4%） was significantly higher than that of the control group （55.8%）. Conclusions Neoadjuvant chemoradiotherapy, hyperthermia combined laparoscopic operation therapy can decrease the tumor stage and operation trauma, improve the postoperative recovery and long-term prognosis, and be of significance in clinical practice.