术中及术后早期腹腔或盆腔热灌注化疗治疗结直肠癌的临床观察  

The clinical application of perioperative continuous hyperthermic peritoneal or pelvic perfusion chemotherapy to treat colorectal cancer

作　　者：魏志刚[1] 卿三华[1] 巴明臣[2] 崔书钟[2] 

机构地区：[1]南方医科大学南方医院普通外科,510515 [2]广州医学院广州市肿瘤医院腹部外科,510095

出　　处：《结直肠肛门外科》2007年第2期75-78,共4页Journal of Colorectal & Anal Surgery

摘　　要：目的:探讨术中和术后早期腹腔或盆腔热灌注化疗治疗结直肠癌的可行性、安全性、毒副作用、并发症和短期抗癌疗效。方法:对住院治疗的20例进展期结直肠癌患者行根治性或姑息性切除后,术中行腹腔热灌注化疗1次,术后4d每日腹腔热灌注化疗1次,化疗液加热至43～44℃,循环灌注60～90min,共5次;直肠癌患者术中盆腔热灌注化疗1次。结果:术中及术后早期行腹腔或盆腔热灌注化疗成功率为100%,热化疗时间内腹腔内化疗液温度均可达到41～43℃,并恒定保持60～90min。热灌注化疗期间患者生命体征无明显异常,除暂时性发热、腹胀、腹痛外无其它不适,直肠癌患者盆腔少量出血1例,切口愈合延迟1例,无其它明显毒副作用及并发症。随诊率100%,随访3～17个月。其中腹腔转移2例,盆腔转移1例,局部复发率为15%,肝转移1例,肝转移率6·2%;结肠癌、直肠癌患者中各有1例分别在术后14、10个月死于全身广泛转移。结论:围手术期腹腔或盆腔热灌注化疗结直肠癌安全可行,治疗不受环境限制,并可多次进行,毒副作用小,并发症少,可能有利于杀灭腹腔内残余微小癌灶(MC)和游离癌细胞(FCC)。Objective： To evaluate the feasibility, safety, side effect, complications and short-term efficacy of perioperative continuous hyperthermic peritoneal or pelvic perfusion chemotherapy （CHPPC） for colorectal cancer. Methods： Twenty patients with advanced colorectal cancer underwent radical or palliative resection. The patients with colon cancer underwent CHPPC using 5-Fu and mitomycin once in the operation, then received CHPPC using only 5-Fu once per day from postoperative day 1 to day 4. The hyperthermic perfusion lasted 60～90 minutes at 43～44℃. The patients with rectal cancer received intraoperative CHPPC once. Results： The successful rate of intraoperative and postoperative CHPPC was 100%. The temperature during thermochemotherapy was maintained 41～43℃ for 60～90 minutes. There were no obvious changes in vital signs during perfusion except temporal fever, abdominal distention and abdominal pain. All the cases were followed up for 3～17 months. Of all the cases, 2 suffered from postoperative regional recurrence （12.5%）, 1 hepatic metastasis （6.2%）. One patient with colon cancer and 1 patient with rectal cancer died of extensive metastasis in 14 and 10 months respectively. Conclusion： Perioperative CHPPC for colorectal cancer is safe, feasible, with less side effects and complications, and can be repeated without the restriction of therapeutic environment.

关 键 词：腹腔热灌注化疗 盆腔热灌注化疗 结直肠癌 

分 类 号：R735.3[医药卫生—肿瘤]