KẾT QUẢ PHẪU THUẬT NỘI SOI ĐIỀU TRỊ UNG THƯ BIỂU MÔ TUYẾN TRỰC TRÀNG GIỮA VÀ DƯỚI CÓ HÓA XẠ TRỊ DÀI NGÀY TRƯỚC MỔ

Abstract

laparoscopic surgery for middle and low rectal adenocarcinoma after long-course neoadjuvant chemoradiotherapy. Methods: A retrospective–prospective study was conducted on 168 patients with stage II–III rectal cancer of the middle and lower third who underwent long-course chemoradiotherapy combined with curative laparoscopic resection at the 108 Military Central Hospital (from August 2018 to August 2023, with follow-up until May 2025). Results: Laparoscopic procedures were successfully performed in most cases (97.62%), with a conversion rate of 2.38% and intraoperative complication rate of 5.36%. Early postoperative complications included urinary retention (6.71%) and anastomotic leakage (4.96%). No perioperative mortality was recorded. Pathological complete response was achieved in 22.02% of patients. Bowel function gradually improved over time, especially in sphincter-preserving procedures. The 1-, 3-, and 5-year overall survival rates were 99.4%, 91.1% and 82.7%, while the disease-free survival rates were 95.7%, 85.6% và 80.7%, respectively. Conclusions: Laparoscopic surgery after long-course chemoradiotherapy for middle and low rectal cancer is safe, feasible, and effective. It increases the likelihood of sphincter preservation, ensures low complication rates, and improves long-term survival outcomes.