ABSTRACT
Objective:To evaluate the clinical efficacy of thermal-therapy combined with 125 I radioactive particles by comparing the results of preoperative and postoperative images,serum carcino-embryonic antigen (CEA) and following-up after treatment of the patients with recurrent rectal cancer.Methods:Nineteen rectal cancer patients with postoperative recurrence after radiotherapy were treated with 125I implantation guided by CT (20 cases were treated with operation,but 1 patient was exited who couldn't tolerate the thermal-therapy).Radioactive particle treatment planning system (TPS) was used to make the plan before the particle implantation,and the distance of the particle was 1.0 cm;all patients received CT scanning and were quantificationally evaluatated after implantation;the number of seeded particles was about 12-58,the radioactivity of the 125I particle was 0.5 mCi,and the matching dose surrounding the tumor was 90-140 Gy.All patients were treated with microwave thermal-therapy after particle implantation,60 min per time,lasting the temprature at 43℃,twice per week,for three weeks.And the patients were followed up after treatment for 3 months,the efficacy was evaluated by image and CEA results,and the urinary frequency,dysuria,hematuria and rectal bleeding were evaluated.Results:Compred with before treatment,after following up for 6 months,the image results showed that the tumor volume was reduced,and the blood CEA level of all patients were decreased from (30.25±8.32) mg · L-1 to (11.89±5.22) mg · L-1 (t=13.158,P＜0.01);the local efficacy was 94.7％ (18/19),and the pain relief rate was 94.4％ (17/18);the NRS median was 6 (4,7) before treatment,and it was 1 (0,3) after treatment,there was significant difference (P＜0.001).There were no frequent urination,urinary pain,hematuria,rectal bleeding and other complications in all patients.Conclusion:Thermal-therapy combined with 125I radioactive particle implantation has good curative effects on the recurrent rectum cancer,and is effective means for recurrent rectum cancer treatment.
ABSTRACT
Objective To compare the clinical efficacy of robotic low anterior resection (R-LAR) and laparoscopic low anterior resection(L-LAR) for rectal cancer.Methods The case-control studies for comparing the clinical efficacy of R-LAR and LLAR for rectal cancer were retrieved from databases,including PubMed,OVID,Springer,Wanfang and VIP,till June 2016.The studies were selected in accordance with inclusion and exclusion critera,and the data were extracted and evaluated by two researchers.The RevManS.3 software was used for Meta-analysis.Results A total of 7 studies including 1 126 patients with rectal cancer were included,592 cases in the R-LAR group and 534 cases in the L-LAR group.Compared with the L-LAR group,in the R-LAR group the operation time was longer (MD=33.84,95％ CI:4.25-63.43,P =0.03),the conversion rate was lower (OR =0.10,95％CI:0.03-0.36,P=0.000 5),and more lymph nodes were dissected (MD=1.24,95％CI:0.31-2.17,P=0.009).No statistically significant difference was found in length of hospital stay,intraoperative blood loss,distance from distal margin to tumor and incidence rate of postoperative anastomotic leakage between the two groups (P ＞ 0.05).Conclusion Compared with L-LAR,RLAR is characterized by longer operation time,lower conversion rate and more thoroughly removing lymph nodes.And the length of hospital stay,intraoperative blood loss,distance from distal margin to tumor and incidence rate of postoperative anastomotic leakage of R-LAR are similar to those of L-LAR.
ABSTRACT
Objective:To evaluate the clinical efficacy of thermal-therapy combined with 125 I radioactive particles by comparing the results of preoperative and postoperative images,serum carcino-embryonic antigen (CEA) and following-up after treatment of the patients with recurrent rectal cancer.Methods:Nineteen rectal cancer patients with postoperative recurrence after radiotherapy were treated with 125I implantation guided by CT (20 cases were treated with operation,but 1 patient was exited who couldn't tolerate the thermal-therapy).Radioactive particle treatment planning system (TPS) was used to make the plan before the particle implantation,and the distance of the particle was 1.0 cm;all patients received CT scanning and were quantificationally evaluatated after implantation;the number of seeded particles was about 12-58,the radioactivity of the 125I particle was 0.5 mCi,and the matching dose surrounding the tumor was 90-140 Gy.All patients were treated with microwave thermal-therapy after particle implantation,60 min per time,lasting the temprature at 43℃,twice per week,for three weeks.And the patients were followed up after treatment for 3 months,the efficacy was evaluated by image and CEA results,and the urinary frequency,dysuria,hematuria and rectal bleeding were evaluated.Results:Compred with before treatment,after following up for 6 months,the image results showed that the tumor volume was reduced,and the blood CEA level of all patients were decreased from (30.25±8.32) mg · L-1 to (11.89±5.22) mg · L-1 (t=13.158,P＜0.01);the local efficacy was 94.7％ (18/19),and the pain relief rate was 94.4％ (17/18);the NRS median was 6 (4,7) before treatment,and it was 1 (0,3) after treatment,there was significant difference (P＜0.001).There were no frequent urination,urinary pain,hematuria,rectal bleeding and other complications in all patients.Conclusion:Thermal-therapy combined with 125I radioactive particle implantation has good curative effects on the recurrent rectum cancer,and is effective means for recurrent rectum cancer treatment.
ABSTRACT
Objective To compare the clinical efficacy of robotic low anterior resection (R-LAR) and laparoscopic low anterior resection(L-LAR) for rectal cancer.Methods The case-control studies for comparing the clinical efficacy of R-LAR and LLAR for rectal cancer were retrieved from databases,including PubMed,OVID,Springer,Wanfang and VIP,till June 2016.The studies were selected in accordance with inclusion and exclusion critera,and the data were extracted and evaluated by two researchers.The RevManS.3 software was used for Meta-analysis.Results A total of 7 studies including 1 126 patients with rectal cancer were included,592 cases in the R-LAR group and 534 cases in the L-LAR group.Compared with the L-LAR group,in the R-LAR group the operation time was longer (MD=33.84,95％ CI:4.25-63.43,P =0.03),the conversion rate was lower (OR =0.10,95％CI:0.03-0.36,P=0.000 5),and more lymph nodes were dissected (MD=1.24,95％CI:0.31-2.17,P=0.009).No statistically significant difference was found in length of hospital stay,intraoperative blood loss,distance from distal margin to tumor and incidence rate of postoperative anastomotic leakage between the two groups (P ＞ 0.05).Conclusion Compared with L-LAR,RLAR is characterized by longer operation time,lower conversion rate and more thoroughly removing lymph nodes.And the length of hospital stay,intraoperative blood loss,distance from distal margin to tumor and incidence rate of postoperative anastomotic leakage of R-LAR are similar to those of L-LAR.
