腹腔镜辅助腹腔热灌注化疗治疗结直肠癌引起的恶性腹水临床疗效及安全性

Clinical effect and safety of laparoscopic assisted hyperthermic intraperitoneal chemotherapy(HIPEC) in the treatment of malignant ascites caused by peritoneal metastasis of colorectal cancer

目的探讨腹腔镜辅助腹腔热灌注化疗(HIPEC)治疗结直肠癌引起恶性腹水的临床疗效及安全性。方法回顾性分析2014年1月至2015年5月诊断结直肠癌并合并恶性腹水患者35例,分为原发组19例和术后复发组16例,均进行腹腔镜辅助置管腹腔热灌注化疗。采用SPSS 20.0统计分析软件进行分析,HIPEC治疗有效率和术后并发症采用卡方检验;KPS评分采用均数±标准差表示,独立t检验,P<0.05为差异有统计学意义。结果 HIPEC治疗后总有效率为100%,其中完全缓解率85.7%(30/35);两组患者灌注后4周KPS评分较灌注前上升0~20分,原发组上升更明显(P=0.000);术后复发组不良反应发生率显著高于原发组(P<0.05)。结论腹腔镜辅助置管HIPEC能缓解结直肠癌引起的恶性腹水,提高患者的生活质量,具有良好的安全性。

Objective To explore the clinical efficacy and safety of laparoscopic assisted intraperitoneal hyperthermic infusion chemotherapy(HIPEC) in the treatment of malignant ascites caused by peritoneal metastasis of colorectal cancer. Methods 35 patients from January 2014 to May 2015 diagnosed colorectal cancer and malignant ascites were analyzed retrospectively, all patients were divided into primary group(n=19) and postoperative recurrence group(n=16), all patients were treated with HIPEC. SPSS 20.0 statistical analysis software was used for analysis, Chi-square test was used to evaluate the effective rate of HIPEC and postoperative complication, KPS score was expressed as (x^-±s) deviation and compared with independent t test, P <0.05 showed significant difference. Results The total effective rate was 100% after HIPEC, of which complete remission rate was 85.7%(30/35). In both groups, the KPS score was increased by 0~20 points at 4 weeks after HIPEC, and primary group was increased more obvious(P=0.000). The adverse reactions of postoperative recurrence group were significantly higher than primary group,(P<0.05). Conclusion Laparoscopical assisted HIPEC can relieve malignant ascites caused by colorectal cancer, and improve patients′ quality of life, and it has good safety.