AIM:To investigate the procedure, feasibility and effects of laparoscopeassisted continuous circulatory hyperthermic intraperitoneal perfusion chemotherapy (CHIPC) in treatment of malignant ascites induced by peritone...AIM:To investigate the procedure, feasibility and effects of laparoscopeassisted continuous circulatory hyperthermic intraperitoneal perfusion chemotherapy (CHIPC) in treatment of malignant ascites induced by peritoneal carcinomatosis from gastric cancers. METHODS: From August 2006 to March 2008, the laparoscopic approach was used to perform CHIPC on 16 patients with malignant ascites induced by gastric cancer or postoperative intraperitoneal seeding. Each patient underwent CHIPC three times after laparoscopeassisted perfusion catheters placing. The first session was completed in operative room under general anesthesia, 5% glucose solution was selected as perfusion liquid, and 1500 mg 5 fluorouracil (5FU) and 200 mg oxaliplatin were added in the perfusion solution. The second andthird sessions were performed in intensive care unit, 0.9% sodium chloride solution was selected as perfusion liquid, and 1500 mg 5FU was added in the perfusion solution alone. CHIPC was performed for 90 min at a velocity of 450600 mL/min and an in flow temperature of 43 ± 0.2℃.RESULTS: The intraoperative course was uneventful in all cases, and the mean operative period for laparoscopeassisted perfusion catheters placing was 80 min for each case. No postoperative deaths or complications related to laparoscopeassisted CHIPC occurred in this study. Clinically complete remission of ascites and related symptoms were achieved in 14 patients, and partial remission was achieved in 2 patients. During the followup, 13 patients died 29 mo after CHIPC, with a median survival time of 5 mo. Two patients with partial remission suffered from port site seeding and tumor metastasis,and died 2 and 3 mo after treatment. Three patients who are still alive today survived 4, 6 and 7 mo, respectively. The Karnofsky marks of patients (5090) increased significantly (P < 0.01) and the general status improved after CHIPC. Thus satisfactory clinical efficacy has been achieved in these patients treated by laparoscopic CHIPC. CONCLUSION: Laparoscopeassisted CHIPC i展开更多
目的探讨腹腔热灌注化疗对结直肠癌术后患者免疫功能、肿瘤标记物、围术期相关并发症及治疗期间不良反应的影响。方法回顾性分析2016年1月1日-2017年12月31日解放军总医院普通外科二病区收治的256例结直肠癌患者临床资料,所有患者均接...目的探讨腹腔热灌注化疗对结直肠癌术后患者免疫功能、肿瘤标记物、围术期相关并发症及治疗期间不良反应的影响。方法回顾性分析2016年1月1日-2017年12月31日解放军总医院普通外科二病区收治的256例结直肠癌患者临床资料,所有患者均接受了腹腔镜根治性手术,术后行腹腔热灌注化疗联合静脉化疗(联合组)112例,单纯行静脉化疗(化疗组)144例。比较两组患者术前术后TNF-α、CRP、IL-6水平,治疗前后T淋巴细胞比例、肿瘤标记物,围术期相关并发症、治疗期间不良反应,术后半年局部复发、远处转移及生存情况。结果两组患者基线资料差异无统计学意义。术后1 d TNF-α[(62.86±9.13) ng/L vs (66.42±11.72) ng/L]、CRP[(46.47±7.58) ng/L vs (49.31±10.03) ng/L]、IL-6[(40.27±8.36) ng/L vs(43.29±9.66) ng/L]联合组低于化疗组(P均<0.05)。4周期化疗后CD3+、CD4+T淋巴细胞以及CD4+/CD8+比值联合组均高于化疗组(CD3+,71.83%±8.61%vs 68.77%±9.18%;CD4+,31.64%±4.83%vs 30.01%±5.06%;CD4+/CD8+,1.17%±0.15%vs1.10%±0.19%;P均<0.05)。两组手术并发症、化疗不良反应差异无统计学意义。术后半年局部复发联合组低于化疗组(0 vs 5.6%,P <0.05),两组远处转移及生存情况差异无统计学意义。结论腹腔热灌注化疗联合静脉化疗相较于单纯静脉化疗,能够减少术后炎性因子的释放,有助于改善结直肠癌术后患者的免疫功能,减少肿瘤的局部复发,同时不增加围术期相关并发症及化疗期间不良反应。展开更多
基金Supported by Funds for Breakthroughs in Key Areas of Guang-dong and Hong Kong Projects, No. 2006Z1-E6041funds for Guangdong Provincial Science and Technology Programs, No. 2009A030301013
文摘AIM:To investigate the procedure, feasibility and effects of laparoscopeassisted continuous circulatory hyperthermic intraperitoneal perfusion chemotherapy (CHIPC) in treatment of malignant ascites induced by peritoneal carcinomatosis from gastric cancers. METHODS: From August 2006 to March 2008, the laparoscopic approach was used to perform CHIPC on 16 patients with malignant ascites induced by gastric cancer or postoperative intraperitoneal seeding. Each patient underwent CHIPC three times after laparoscopeassisted perfusion catheters placing. The first session was completed in operative room under general anesthesia, 5% glucose solution was selected as perfusion liquid, and 1500 mg 5 fluorouracil (5FU) and 200 mg oxaliplatin were added in the perfusion solution. The second andthird sessions were performed in intensive care unit, 0.9% sodium chloride solution was selected as perfusion liquid, and 1500 mg 5FU was added in the perfusion solution alone. CHIPC was performed for 90 min at a velocity of 450600 mL/min and an in flow temperature of 43 ± 0.2℃.RESULTS: The intraoperative course was uneventful in all cases, and the mean operative period for laparoscopeassisted perfusion catheters placing was 80 min for each case. No postoperative deaths or complications related to laparoscopeassisted CHIPC occurred in this study. Clinically complete remission of ascites and related symptoms were achieved in 14 patients, and partial remission was achieved in 2 patients. During the followup, 13 patients died 29 mo after CHIPC, with a median survival time of 5 mo. Two patients with partial remission suffered from port site seeding and tumor metastasis,and died 2 and 3 mo after treatment. Three patients who are still alive today survived 4, 6 and 7 mo, respectively. The Karnofsky marks of patients (5090) increased significantly (P < 0.01) and the general status improved after CHIPC. Thus satisfactory clinical efficacy has been achieved in these patients treated by laparoscopic CHIPC. CONCLUSION: Laparoscopeassisted CHIPC i
文摘目的探讨腹腔热灌注化疗对结直肠癌术后患者免疫功能、肿瘤标记物、围术期相关并发症及治疗期间不良反应的影响。方法回顾性分析2016年1月1日-2017年12月31日解放军总医院普通外科二病区收治的256例结直肠癌患者临床资料,所有患者均接受了腹腔镜根治性手术,术后行腹腔热灌注化疗联合静脉化疗(联合组)112例,单纯行静脉化疗(化疗组)144例。比较两组患者术前术后TNF-α、CRP、IL-6水平,治疗前后T淋巴细胞比例、肿瘤标记物,围术期相关并发症、治疗期间不良反应,术后半年局部复发、远处转移及生存情况。结果两组患者基线资料差异无统计学意义。术后1 d TNF-α[(62.86±9.13) ng/L vs (66.42±11.72) ng/L]、CRP[(46.47±7.58) ng/L vs (49.31±10.03) ng/L]、IL-6[(40.27±8.36) ng/L vs(43.29±9.66) ng/L]联合组低于化疗组(P均<0.05)。4周期化疗后CD3+、CD4+T淋巴细胞以及CD4+/CD8+比值联合组均高于化疗组(CD3+,71.83%±8.61%vs 68.77%±9.18%;CD4+,31.64%±4.83%vs 30.01%±5.06%;CD4+/CD8+,1.17%±0.15%vs1.10%±0.19%;P均<0.05)。两组手术并发症、化疗不良反应差异无统计学意义。术后半年局部复发联合组低于化疗组(0 vs 5.6%,P <0.05),两组远处转移及生存情况差异无统计学意义。结论腹腔热灌注化疗联合静脉化疗相较于单纯静脉化疗,能够减少术后炎性因子的释放,有助于改善结直肠癌术后患者的免疫功能,减少肿瘤的局部复发,同时不增加围术期相关并发症及化疗期间不良反应。
