腹腔镜术中局部使用5-氟尿嘧啶缓释剂对进展期结直肠癌患者远期生存率的影响  

Effect of local use of 5-Fu sustained release agent in laparoscopic surgery on long term survival rate of patients with advanced colorectal cancer

作　　者：杨东海 牛文博[2] 

机构地区：[1]河北邢台医专第二附属医院,河北邢台054000 [2]河北医科大学第四医院,河北石家庄050010

出　　处：《中国临床研究》2016年第5期605-608,共4页Chinese Journal of Clinical Research

基　　金：河北省2014年度医学科学研究课题计划项目(ZL20140015)

摘　　要：目的探讨术中局部植入5-氟尿嘧啶(5-Fu)缓释剂对进展期结直肠癌患者远期生存率的影响。方法将120例进展期结直肠癌患者按照随机数字表法分为植入组(60例)和冲洗组(60例)。所有患者均行腹腔镜手术,冲洗组于手术中给予5-Fu注射液冲洗腹腔,植入组于手术关腹前局部植入5-Fu缓释剂。对比两组并发症、毒副反应及术后各时点复发率、远处转移率和生存率情况。结果植入组术后并发症发生率和毒副反应发生率分别为11.7%和28.3%,均稍低于冲洗组的16.7%和41.7%,但差异均无统计学意义(P均>0.05);植入组术后6、12、24个月各时点复发率、远处转移率均稍低于冲洗组,生存率稍高于冲洗组,但差异均无统计学意义(P均>0.05);而术后36个月时植入组复发率和远处转移率明显低于冲洗组,且生存率明显高于冲洗组,差异均有统计学意义(P均<0.05)。结论对进展期结直肠癌患者腹腔镜术中局部植入5-Fu缓释剂可以显著改善远期复发率、远处转移率和生存率,且术后并发症和毒副反应较少。Objective To explore the effect of local use of 5-fluorouracil（ 5-Fu） sustained release agent in laparoscopic surgery on long term survival rate in patients with advanced colorectal cancer. Methods A total of 120 patients with advanced colorectal cancer were divided into implantation group（ 60 cases） and flushing group（ 60 cases） according to the random number table method. All patients were treated with laparoscopic surgery. As laparoscopic surgery was performed,the 5-Fu injection was used in the operation to wash the abdominal cavity in flushing group,and the 5-Fu sustained release agent was locally implanted before closing abdominal cavity in implantation group. The complications,the toxic and side effects and recurernce rate at each time point,distance metastasis rate and survival rate after operation between two groups were compared. Results The incidences of postoperative complications（ 11. 7%） and toxic and side effects（ 28. 3%） in implantation group were slightly lower than those（ 16. 7%,41. 7%） in flushing group,but there were no significant differences between two groups（ all P 0. 05）. The recurernce rates at 6-,12- and 24-month after operation,distance metastasis rate in implantation group were slightly lower than those in flushing group,and survival rate in implantation group was slightly higher than that in flushing group,but there were all no significant differences（ all P 0. 05）. At 36-month after operation,the recurernce rates,distance metastasis rate in implantation group were significantly lower than those in flushing group,and survival rate in implantation group was significantly higher than that in flushing group（ all P 0. 05）. Conclusion The local implantation of 5-Fu sustained release agent in laparoscopic surgery can significantly improve long term recurernce rate,distance metastasis rate and survival rate and decrease the postoperative complications and the toxic and side effects.

关 键 词：腹腔镜手术 5-氟尿嘧啶缓释剂 结直肠癌 进展期 远期生存率 并发症 复发率 远处转移 

分 类 号：R753.3[医药卫生—皮肤病学与性病学]