Objective: To investigate the safety and feasibility of endoscopic full-thickness resection (EFTR) in the treatment of near-clinical complete response (near-cCR) rectal cancer after neoadjuvant therapy. Methods: A 74-year-old female patient with cT3N0M0 stage rectal adenocarcinoma who refused radical surgery for rectal cancer underwent neoadjuvant chemoradiotherapy (5 cycles of CapeOx chemotherapy and concurrent radiotherapy for 25 sessions) after multidisciplinary team discussion. One month after completing neoadjuvant treatment, reassessment including digital rectal examination, colonoscopy, and pelvic enhanced magnetic resonance imaging suggested near-cCR. Despite this, the patient requested rectal-preserving therapy. Subsequently, EFTR was performed five weeks after completion of neoadjuvant treatment. Postoperatively, supportive care including fasting, antimicrobial therapy, and nutritional support was provided. The patient started a liquid diet on the 6th day postoperatively and was discharged on the 13th day. Results: Pathological analysis revealed tubular adenoma with low-grade epithelial dysplasia, with negative margins and negative involvement of the base. During one-year follow-up, there were no signs of local regrowth or distant metastasis, and satisfactory anal function was observed. Conclusion: EFTR is safe and feasible in patients with near-cCR rectal cancer after neoadjuvant therapy. This approach should be considered after thorough evaluation of the patient's condition.
目的： 探讨内镜下全层切除术在新辅助治疗后近临床完全缓解（near-cCR）直肠癌治疗中的安全性和可行性。 方法： 患者女性，74岁，cT3N0M0期直肠腺癌，患者坚决拒绝行直肠癌根治术，经院内多学科团队讨论后，接受了新辅助放化疗（CapeOx化疗5程，同期放疗25次）。完成新辅助治疗后1个月复查直肠指检、肠镜、盆腔增强磁共振等辅助检查，考虑为near-cCR，患者仍要求行保肛治疗，遂于新辅助治疗结束后5周行直肠内镜下全层切除术（EFTR）。术后予禁食、抗感染、营养支持等对症支持治疗，第6天开放流质饮食，第13天出院。 结果： 病理结果：管状腺瘤伴低级别上皮内瘤变，切缘及基底均阴性。术后1年随访期间未见局部再生或远处转移征象，肛门功能满意。 结论： 新辅助治疗后near-cCR的直肠癌患者，经充分评估后行EFTR安全可行。.