Effect of neoadjuvant therapy on early postoperative complications in rectal cancer.

Q4 Medicine
F Pazdírek, M Vjaclovský, M Grega, J Hoch
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引用次数: 0

Abstract

Introduction: The treatment of locally advanced rectal cancer is multimodal. It includes neoadjuvant chemoradiotherapy (NCHRT). NCHRT has been shown to reduce the risk of local recurrence. New treatment regimens also have a positive impact on patient survival. NCHRT leads to fibrotic changes in the pelvis and is associated with side effects. NCHRT may have a negative impact on postoperative complications. The aim of this study was to demonstrate whether NCHRT increases the number of early postoperative complications.

Methods: An analysis of our own cohort of 200 patients with rectal cancer undergoing robotic-assisted surgery between 2018 and 2022 was performed. The cohort was divided into patients who underwent NCHRT and subsequently surgery and patients who underwent primary surgery. The two groups were compared in terms of duration of surgery, blood loss, incidence of anastomotic complications, and quality of mesorectal excision.

Results: Patients who underwent NCHRT had a longer operation time, by 34 minutes on average. We did not demonstrate a higher incidence of anastomotic complications in these patients. Patients who underwent primary surgery had a slightly lower blood loss and better quality of mesorectal excision during surgery. Nevertheless, complete or nearly complete mesorectal anastomosis was achieved in more than 85% of cases in both groups.

Conclusion: Radiotherapy results in postradiation changes in the lesser pelvis. These changes impair visibility and dissection during surgery. Operations after NCHRT are more technically demanding and take longer but do not have more anastomotic complications. Also, the quality of mesorectal excision is satisfactory in both groups.

新辅助治疗对直肠癌术后早期并发症的影响
介绍:局部晚期直肠癌的治疗是多模式的。其中包括新辅助放化疗(NCHRT)。事实证明,新辅助化放疗可降低局部复发的风险。新的治疗方案对患者的生存也有积极影响。NCHRT 会导致骨盆纤维化,并伴有副作用。NCHRT 可能会对术后并发症产生负面影响。本研究的目的是证明 NCHRT 是否会增加术后早期并发症的数量:我们对 2018 年至 2022 年间接受机器人辅助手术的 200 名直肠癌患者进行了分析。该队列分为接受 NCHRT 并随后接受手术的患者和接受初级手术的患者。两组患者在手术时间、失血量、吻合口并发症发生率和直肠系膜切除质量方面进行了比较:结果:接受 NCHRT 的患者手术时间更长,平均延长了 34 分钟。我们没有发现这些患者的吻合口并发症发生率更高。接受初级手术的患者失血量稍低,手术中直肠间膜切除的质量较好。尽管如此,两组患者中均有超过85%的病例实现了完全或接近完全的直肠系膜吻合:结论:放疗会导致小骨盆在放疗后发生变化。结论:放疗会导致小盆腔放疗后改变,这些改变会影响手术中的可见度和解剖。NCHRT 后的手术对技术要求更高,所需时间更长,但吻合并发症并不多。此外,两组患者的直肠系膜切除质量都令人满意。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Rozhledy v Chirurgii
Rozhledy v Chirurgii Medicine-Medicine (all)
CiteScore
0.50
自引率
0.00%
发文量
67
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