氟尿嘧啶缓释剂在腹腔镜局部进展期结直肠癌手术中应用的临床研究

Clinical research on the effects of intraoperative intraperitoneal chemotherapy with sustained-release 5-fluorouracil for laparoscopic treatment of locally advanced colorectal cancer

目的评价腹腔镜手术中局部植入氟尿嘧啶缓释剂对局部进展期结直肠癌腹腔镜手术的治疗作用。方法对60例局部进展期(T4N0M0及Ⅲ期)结直肠癌患者行腹腔镜结直肠癌根治性手术,分为治疗组(n=29):术中局部植入氟尿嘧啶缓释剂600 mg;对照组(n=31):术中以氟尿嘧啶注射液1 000 mg冲洗腹腔。两组患者术后化疗方案相同。回顾性分析两组患者的局部复发和远处转移例数以及3年生存率。结果治疗组的1年、3年局部复发率和远处转移率以及1年、3年生存率均优于对照组(P<0.05)。结论术中局部植入氟尿嘧啶缓释剂可降低腹腔镜局部进展期结直肠癌术后局部复发率,并可提高3年生存率。

Objective To assess the effects of intraoperative intraperitoneal chemotherapy with sustained release 5-fluorouracil for inplantation for the laparoscopic treatment of locally advanced colorectal cancer. Methods A total of 60 patients with locally advanced primary colorectal cancer （T4N0M0 and stage Ⅲ） undergoing lapa- roscopic radical resection were divided into treatment group （n = 29, intraoperative intraperitoneal chemotherapy with 600 mg sustained release 5-fluorouracil） and control group（ n = 31, intraoperative intraperitoneal flushing with 1 000 mg 5-fluorouracil injection）. Both groups received the same postoperative chemotherapy regime. The 3-year survival rate, local recurrence rate and distant metastasis rate were retrospectively analysed. Results The 3-year survival rate and local recurrence rate were more favorable in treatment group than those in control group （ P 〈 0. 05） ,while there was no significant difference in distant metastasis rate between these two groups （P 〉 0. 05 ）. Conclusions Intraoperative intraperitoneal chemotherapy with sustained release 5-fluorouracil may decrease post-operative local recurrence rate and increase 3-year survival rate of locally advanced colorectal cancer.