腹腔镜下结直肠癌根治术中联合腹腔热灌注化疗的临床研究

Laparoscopic colorectal cancer resection in combination with intraoperative intraperitoneal hyperthermic perfusion chemotherapy

目的:探讨腹腔镜下结直肠癌根治术中联合腹腔热灌注化疗(IHPC)的安全性及可行性。方法:将120例进展期结直肠癌患者随机分成治疗组和对照组,每组各60例。两组患者均接受腹腔镜下结直肠癌根治术,治疗组术中行IHPC联合术后m FOLFOX6方案静脉化疗;对照组单纯行术后m FOLFOX6方案静脉化疗。比较两组患者手术相关指标、术后恢复情况、术后并发症、不良反应、局部复发率及远处转移率。结果:两组患者在手术相关指标、术后恢复情况、术后并发症方面差异均无统计学意义(均P>0.05);治疗组术后低蛋白血症和低钠血症的发生率明显高于对照组(20.0%vs.6.7%;15.0%vs.3.3%,均P<0.05);腹腔局部复发率和远处转移率明显低于对照组(6.7%vs.18.3%;8.3%vs.23.3%,均P<0.05);两组短期总生存率相当(P>0.05)。结论:腹腔镜下结直肠癌根治术中IHPC联合术后静脉化疗安全可靠,对局部复发及远处转移疗效较好。

Objective：To investigate the safety and feasibility of laparoscopic colorectal cancer resection cancer in combination with intraoperative intraperitoneal hyperthermic perfusion chemotherapy（IHPC）.Methods：One-hundred and twenty patients with advanced colorectal cancer were randomly divided into treatment group and control group with 60 cases in each group.All patients underwent laparoscopic colorectal cancer resection.Patients in treatment group received intraoperative IHPC combined with postoperative systemic chemotherapy with m FOLFOX6 regimen,while those in control group were given postoperative systemic chemotherapy with m FOLFOX6 regimen only.The surgery-related parameters,postoperative recovery,complications,adverse reactions,local recurrence and distant metastasis between the two groups of patients were compared.Results：h ere was no signii cant dif erence with respect to surgery-related parameters,postoperative recovery and incidence of postoperative complications between the two groups（all P〉0.05）.The incidences of postoperative hypoalbuminemia and hyponatremia were significantly increased in treatment group compared with control group（20.0% vs.6.7%; 15.0% vs.3.3%,both P〈0.05）,while the rates of peritoneal local recurrence and distant metastasis were signii cantly lower in treatment group than those in control group（6.7% vs.18.3%; 8.3% vs.23.3%,both P〈0.05）.The short-term overall survival rates were similar between the two groups（P〉0.05）.Conclusion：IHPC in laparoscopic colorectal cancer resection followed by postoperative systemic chemotherapy is safe and reliable,and has some efficacy in reducing local recurrence and distant metastasis.