Kết quả xa phẫu thuật nội soi ung thư trực tràng giữa và thấp sau hóa xạ trị tiền phẫu=Long-term results laparoscopic surgery for middle and low rectal cancer after preoperative chemoradiotherapy

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Tác giả: Ngọc Hà Hoàng, Quang Dũng Lưu, Đức Phan Nguyễn, Đức Huấn Phạm, Bảo Long Trần, Ngọc Dũng Trần

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Nghiên cứu y học (Đại học Y Hà Nội), 2024

Mô tả vật lý: tr.85-93

Bộ sưu tập: Metadata

ID: 244813

Thêm vào giỏ

Phẫu thuật kết hợp với hóa xạ trị trước phẫu thuật làm giảm tỷ lệ tái phát sau phẫu thuật. Đề tài nhằm mục tiêu đánh giá kết quả xa điều trị ung thư trực tràng giữa và thấp bằng phẫu thuật nội soi sau hóa xạ trị tiền phẫu. Nghiên cứu 62 bệnh nhân ung thư trực tràng giữa và thấp được điều trị bằng phẫu thuật nội soi và hóa/ xạ tiền phẫu từ 1/2017 đến 8/2022. Tuổi trung bình 59,6 ± 10,9 với tỉ lệ nam và nữ 1,2. Tỉ lệ các phương pháp phẫu thuật: nối đại tràng - trực tràng, nối đại tràng - ống hậu môn, phẫu thuật Hartmann, phẫu thuật Miles với tỉ lệ 50,7%, 16,9%, 4,5%, 17,9%. Tỉ lệ tái phát tại chỗ 3,2%, di căn gan , phổi, phúc mạc lần lượt là 9,7%, 6,7%, 1,6%. Chức năng tự chủ hậu môn Kirwan I - II - III - IV - V lần lượt là 52,1% - 25,0% - 14,6% - 2,1% - 6,2%. Tỉ lệ sống thêm toàn bộ và sống thêm không bệnh sau 5 năm là 81% và 78,1%. Ước lượng thời gian sống thêm toàn bộ và không bệnh trung bình là: 30,1 ± 16,8 và 28,1 ± 17,7 tháng. Kết quả sơ bộ hóa xạ tiền phẫu làm thuận lợi cho phẫu thuật nội soi triệt căn cắt trực tràng giữa và dưới do ung thư, nhằm bảo tồn cơ thắt.Surgery combined with preoperative chemoradiotherapy reduces postoperative recurrence rate. The current study aim of evaluating the long-term results of treating middle and low rectal cancer with laparoscopic surgery after preoperative chemoradiotherapy. 62 patients with mid and low rectal cancer treated with laparoscopic surgery and preoperative chemoradiotherapy were evaluated from January 2017 to August 2022. The average age was 59.6 ± 10.9 with male to female ratio (11/10). The surgical methods were colon - rectal anastomosis, colon - anal anastomosis, Hartmann surgery, Miles surgery with the ratio of 50.7%, 16.9%, 4.5%, 17.9% respectively. Local recurrence rate was 3.23%, liver, lung, peritoneal metastasis was 9.7%, 6.7%, 1.6% respectively. Patients with anal continence according to Kirwan classification level I was 52.1%. Kirwan I - II - III - IV - V anal continence function was 52.1% - 25.0% - 14.6% - 2.1% - 6.2%, respectively. Estimated mean overall survival time and disease-free survival time was: 30.1 ± 16.8. and 28.1 ± 17.7 months. From the preliminary results, we suggest that preoperative chemoradiotherapy facilitates radical laparoscopic surgery of middle and low rectal cancer with sphincter preservation

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