Retrospective study on laparoscopic surgery combined with intraoperative radiotherapy in treatment of locally advanced rectal cancer

doi:10.16139/j.1007-9610.2021.01.010

Abstract

Abstract:

Objective To analyze the efficacy of laparoscopic surgery combined with intraoperative radiotherapy (IORT) using mobile linear accelerator in the treatment of patients with locally advanced rectal cancer (LARC). Methods A retrospective analysis was made on 22 patients with LARC as study group who were treated with laparoscopy combined with IORT in our hospital from January 2012 to January 2016. A total of 44 patients were selected as control group using matched case-control design at 1∶2 based on age, sex, body mass index, mode of operation and tumor TNM stage. The patients in two groups were compared and analyzed. Results Average operative time in study group was longer than that in control group (P=0.024). There was no significant difference in postoperative exhaust time, fluid recovery time, postoperative hospital stay and short-term postoperative complications between study group and control group (P>0.05). The diffe-rences in both no local recurrence rate of 1-year (P=0.742) and 3-year (P=0.533) and overall survival rate of 1-year (P=0.476) and 3-year (P=0.447) were not significant between study group and control group. Conclusions Compared with laparoscopic surgery alone for LARC patients, laparoscopic surgery combined with IORT might increase the operative time. However, there was no significant difference in other operative indexes between two groups. Laparoscopic surgery with IORT could be done safe and feasible, and be comprehensive treatments for LARC patients.

Key words: Intraoperative radiotherapy, Locally advanced rectal cancer, Complication, No local recurrence rate

CLC Number:

R735.37

CHEN Xianze, CHENG Xi, ZHAO Shengguang, ZHANG Tao, SHI Yiqing, LIU Kun, WANG Changgang, JIANG Yimei, JI Xiaopin, ZHAO Ren. Retrospective study on laparoscopic surgery combined with intraoperative radiotherapy in treatment of locally advanced rectal cancer[J]. Journal of Surgery Concepts & Practice, 2021, 26(01): 48-53.

Figures/Tables 6

References 20

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项目	研究组（n=22）	对照组（n=44）
性别
男	10（45.45）	20（45.45）
女	12（54.55）	24（54.55）
中位年龄（岁）	54（29~71）	53（30~72）
BMI
总体	23.15±3.07	23.26±3.18
男	23.35±3.75	24.03±3.84
女	22.65±2.86	22.58±2.94
ASA分级
Ⅰ	16（72.73）	34（77.27）
Ⅱ	6（27.27）	10（22.73）
肿块距离肛缘（cm）	8.0（6.0~12.0）	7.5（5.0~12.0）
T分期
T₃	9（40.91）	18（40.91）
T₄	13（50.09）	26（50.09）
N分期
N₀	8（36.37）	16（36.37）
N₁	9（40.91）	18（40.91）
N₂	5（22.73）	10（22.73）
M分期
M₀	22	44

项目	研究组（n=22）	对照组（n=44）	P值
手术时间（min）	146.7±32.5	118.2±31.3	0.024
术中出血量（mL）	51.8±42.5	52.6±47.2	0.286
淋巴结清扫（枚）	13.1±2.7	12.8±2.5	0.572
下切缘长度（cm）	2.5±0.5	2.6±0.4	0.325

项目	研究组（n=22）	对照组（n=44）	P值
术后排气（d）	2.3（1.0~4.0）	2.2（1.0~4.0）	0.641
进食流质（d）	4.7（3.0~6.0）	4.5（3.0~6.0）	0.749
术后住院（d）	8.9（7.0~30.0）	9.2（7.0~28.0）	0.548

项目	研究组（n=22）	对照组（n=44）	P值
吻合口漏	2（9.09）	4（9.09）	1
尿潴留	1（4.55）	3（6.82）	0.715
腹泻	2（9.09）	3（6.82）	0.742
盆腔疼痛	2（9.09）	3（6.82）	0.742
小肠梗阻	1（4.55）	1（2.27）	0.612
小肠嵌顿疝	1（4.55）	0	0.154
二次手术	1（4.55）	2（4.55）	1

项目	研究组（n=22）	对照组（n=44）	P值
1年无局部复发率	20（90.91）	41（93.18）	0.742
3年无局部复发率	18（81.82）	33（75.00）	0.533
1年总生存率	22（100）	43（97.73）	0.476
3年总生存率	20（90.91）	37（84.09）	0.447