The Function Of Neoadjuvant Chemoradiotherapy In Sphincter Preservation For Advanced Ultra-low Rectal Cancer

Objective:By comparing the colorectal tumor size, TNM staging,anal rate, incidence of postoperative complications, local recurrence rate,survival rate and other indicators to evaluate neoadjuvant chemoradiation in advanced ultra low position rectal cancer anal surgery application value, so as to better guide clinical applicationMethods:Statistics in October 2012- October 2015 in the second hospital of jilin university general hospital surgery advanced ultra low position rectal malignant tumor(tumor bottom from the anus < 4 cm) in patients with clinical data.According to whether to accept preoperative neoadjuvant chemoradiation is divided into A, B two groups, one for preoperative chemoradiotherapy group A total of 19 cases of group A,group B for direct surgical group, A total of 25 cases.Compare two groups of patients with clinical information, protect anal surgery, surgical complications, postoperative anal function, the postoperative local recurrence rate and postoperative 3 year survival rate, etc.Measurement data using t test;Count data by chi-square test, p < 0.05 was statistically significant.Results : Experimental results show that the neoadjuvant therapyafter lower average decrease tumor diameter 1.5 cm, 2 patients for p CR,remission rate was 10.5%.After neoadjuvant chemoradiation, 12 cases of patients had different degree of TNM stage, the total drop period rate was63.2%(12/19).8 group A bartender anus after operation(42.1%) was better than group B line eventually protect anal 3 cases(12%).Two groups of anal rate difference was statistically significant.Two groups of incision healing time, intraoperative blood loss, perioperative complications rate: wound infection rate(15.79% vs16 %), pelvic abscess(10.53% vs12 %), the probability of anastomosis fistula(40% vs33.3 %),the probability of reoperation(5.26% vs4 %), there was no statistically significant difference.3 years of local recurrence rate in group A was significantly lower than that of group B(5.3% : 5.3%)(p < 0.05).Group A3 year Disease-free survival rates is 94.7%, group B was 68% difference there is statistical significance.(p < 0.05).Conclusion:1. The preoperative neoadjuvant chemoradiation can improve advanced low a anal rate of colorectal cancer.2. The preoperative neoadjuvant chemoradiation doesn’t increase the ultra low position rectal cancer incidence of perioperative complications.3. The preoperative neoadjuvant chemoradiation can reduce the development phase of the ultra low position rectal cancer local recurrence rate and improve postoperative 3 years disease-free surial.