直肠癌新辅助治疗后行保直肠手术的争议和前景
Controversies and prospects of rectum preserving surgery after neoadjuvant therapy for rectal cancer
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摘要:
直肠癌治疗有3个目标,一是通过治疗,最大程度降低盆腔局部复发率,降低至5%以下更佳;二是尽可能减少急性或慢性并发症;三是保留良好的括约肌功能和生命质量。直肠癌新辅助治疗后保直肠手术作为一个新理念,在施行过程中仍存在很多争议,包括筛选标准、新辅助治疗方案、治疗方式、并发症、肿瘤学预后及生命质量等。笔者查阅文献并结合自身实践经验,对上述问题展开讨论,旨在为新辅助治疗后行保直肠手术的推广提供参考。
Abstract:There are three goals of the treatments for rectal cancer, including risk reduction of local recurrence in the pelvic cavity through treatment to the most extent (better down to less than 5%), reduction of acute or chronic complications as soon as possible, and preservation of good sphincter function as well as life quality. As a new concept, rectum preserving surgery following neoadjuvant therapy, remains controversial in its implementation process. There are controversies in the selection criteria, regimens of neoadjuvant therapy, therapy procedures, complications, and evaluation of oncological prognosis and life quality. The authors discuss the above issues in this article based on literatures and our own practical experience, in order to provide references for the promotion of rectum preserving surgery.
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