中国实用外科杂志2025，Vol.45Issue(3)：316-321,6.DOI:10.19538/j.cjps.issn1005-2208.2025.03.15
内镜下全层切除术治疗新辅助治疗后近临床完全缓解直肠癌的疗效及安全性研究
Endoscopic full-thickness resection for the treatment of rectal cancer with near-clinical complete response after neoadjuvant therapy:A study on efficacy and safety
摘要
Abstract
Objective To evaluate the feasibility and safety of endoscopic full thickness resection(EFTR)in rectal cancer patients achieving a near clinical complete response(ncCR)following neoadjuvant therapy.Methods A retrospective analysis was conducted on mid-to-low rectal cancer patients who underwent neoadjuvant therapy at Zhongshan Hospital,Fudan University between October 2021 and March 2024.Patients who,upon re-evaluation,achieved ncCR and subsequently underwent EFTR were included.The primary analysis was based on perioperative complications,pathological outcomes,and short term follow up data.Outcome measures included operative time,en bloc resection rate,R0 resection rate,postoperative complications,Wexner score for bowel function,and follow-up results.Results A total of 9 patients with cT2-3N0M0 rectal cancer were enrolled.All patients received capecitabine-based chemoradiotherapy.EFTR was successfully completed in all cases,with a mean operative time of 68.5 minutes.Both the en bloc resection and R0 resection rates were 100％.Postoperative pathological evaluation revealed that 6 cases had only residual mucosal lesions and 3 cases exhibited residual tumor invasion into the submucosa(ypT1).The mean postoperative Wexner score was 6.8.During a follow-up period of 11 to 36 months(median 23 months),no local recurrence,metastasis or death were observed.Conclusion For rectal cancer patients achieving ncCR after neoadjuvant therapy,EFTR appears to be a safe and feasible treatment strategy that attains high en bloc and R0 resection rates and favorable local control during short-term follow-up.Nonetheless,further evaluation is required to determine long-term oncological outcomes.关键词
进展期直肠癌/器官保留/内镜下全层切除术/新辅助放化疗/安全性及有效性Key words
locally advanced rectal cancer/organ preservation/endoscopic full-thickness resection/neoadjuvant chemoradiotherapy/near clinical complete response分类
临床医学引用本文复制引用
董月伦,许剑民,钟芸诗,贺东黎,王燕,李冰,杜嫣妘,阿依木克地斯·亚力孔,齐志鹏,章娴,叶乐驰,王健..内镜下全层切除术治疗新辅助治疗后近临床完全缓解直肠癌的疗效及安全性研究[J].中国实用外科杂志,2025,45(3):316-321,6.基金项目
国家自然科学基金项目(No.82002515,No.82273025,No.82203460) （No.82002515,No.82273025,No.82203460）
上海市科学技术委员会科研计划项目(No.22JC1403003,No.22XD1402200) National Natural Science Foundation of China(No.82002515,No.82273025,No.82203460) （No.22JC1403003,No.22XD1402200）
Shanghai Science and Technology Commission Research Plan Project(No.22JC1403003,No.22XD1402200) （No.22JC1403003,No.22XD1402200）
