Хирургическая тактика после химиолучевой терапии рака прямой кишки
Диссертация
Несмотря на очевидные успехи, связанные с повсеместным внедрением метода «тотальной мезоректумэктомии» при раке прямой кишки неоадъювантная лучевая терапия не утратила своего значения. 5-летние результаты лечения 1861 больного раком прямой кишки II-III стадии, включенного в крупное мультицентровое исследование проведенного в Нидерландах, в котором предоперационная лучевая терапия (СОД 25 Гр, РОД… Читать ещё >
Содержание
- ГЛАВА 1. Обзор литературы
- 1. 1. Эпидемиология рака
- 1. 2. Роль хирургического вмешательства как основополагающего метода лечения рака прямой кишки
- 1. 3. Лучевая терапия в лечении рака прямой кишки
- ГЛАВА 2. Материалы и методы
- 2. 1. Анализ клинических наблюдений
- 2. 2. Методы обследования
- 2. 3. Методика химиолучевой терапии
- 2. 4. Техника хирургических вмешательств по поводу рака прямой кишки
- 2. 5. Методы статистических расчетов
- ГЛАВА 3. Результаты химиолучевой терапии рака прямой кишки
- 3. 1. Переносимость химиолучевой терапии
- 3. 2. Регрессия опухоли как результат химиолучевого лечения рака прямой кишки
- 3. 2. 1. Трансректальное УЗИ исследование в оценке регрессии опухоли прямой кишки под воздействием химиолучевой терапии
- 3. 2. 2. МРТмалого таза в оценке регрессии опухоли прямой кишки под воздействием химиолучевой терапии
- 3. 3. Результаты морфологического исследования удаленного препарата
- 3. 4. Прогнозирование регрессии рака прямой кишки
- ГЛАВА 4. Хирургическое лечение рака прямой кишки
- 4. 1. Виды хирургических вмешательств
- 4. 2. Сфинктеросохраняющие операции и определение факторов прогноза их выполнения
- ГЛАВА 5. Особенности оперативных вмешательств и послеоперационного периода у больных, перенесших предоперационную химиолучевую терапию
- 5. 1. Интраоперационные особенности хирургических вмешательств
- 5. 2. Анализ послеоперационных осложнений
- ГЛАВА 6. Влияние предоперационной химиолучевой терапии на функциональные результаты
- 6. 1. Латентность полового нерва и сократительная способность анальных сфинктеров до и после ХЛТ
- 6. 2. Анализ качества жизни и функции держания пациентов, перенесших сфинктеросохраняющие операции
- ГЛАВА 7. Отдаленные результаты
- 7. 1. Отдаленные результаты лечения больных раком прямой кишки, перенесших предоперационную химиолучевую терапию
- 7. 1. 1. Анализ частоты местных рецидивов и отдаленных метастазов
- 7. 1. 2. Безрецидивная выживаемость
- 7. 2. Отдаленные результаты лечения больных раком прямой кишки, перенесших хирургическое лечение
- 7. 2. 1. Анализ частоты местных рецидивов и отдаленных метастазов
- 7. 2. 2. Безрег (идивная выживаемость
- 7. 3. Сравнительный анализ отдаленных результатов комбинированного и хирургического лечения больных
- 7. 3. 1. Сравнительный анализ частоты местных рег (идивов и отдаленных метастазов
- 7. 3. 2. Сравнительный анализ безрецидивной выживаемости
- 7. 4. Резюме
- 7. 1. Отдаленные результаты лечения больных раком прямой кишки, перенесших предоперационную химиолучевую терапию
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