术中腹腔内温热化疗的术后并发症分析

Analysis of postoperative complications of intraoperative peritoneal hyperthermia-chemotherapy

目的 :评估术中腹腔内温热化疗 (intraop erativeperitonealhyperthermia chemotherapy ,IPHC)的临床安全性。方法 :12 8例侵及浆膜的进展期胃癌病例 ,4 9例行IPHC ,79例对照 (不行IPHC)。比较 2组术后 30d内死亡率和并发症率。结果 :IPHC组未发生手术死亡 ,对照组 1例术后 1wk死亡 ,差异无显著意义 (P >0 .0 5 )。IPHC组的术后并发症率为 2 2 % (11/ 4 9) ,对照组为 13% (10 / 79) ,差异无显著意义 (P >0 .0 5 )。IPHC组肾功能不全发生率 14% (7/ 4 9) ,显著高于对照组的 4 % (3/79) (P <0 .0 5 ) ,术后 1～ 2mo内可恢复 ;IPHC组吻合口漏和肠功能恢复延缓的发生率均为 4 % (2 /4 9) ,对照组分别为 9% (7/ 79)和 0 ,差异无显著意义P >0 .0 5。结论

AIM: To evaluate the safety of clinical usage of intraoperative peritoneal hyperthermia-chemotherapy (IPHC). METHODS: One hundred and twenty-eight serosa-invasive advanced gastric cancer patients were divided into two groups, 49 patients for IPHC group and 79 patients for control group. The 30 d postoperative mortality and complication morbidity rates were compared. RESULTS: IPHC group had no patient died within 30 d, while the control group had one. There was no significant difference in mortality rate between two groups. The complication morbidity rate of IPHC group was 22 % (11/49), while that of the control group was 9 % (10/79), without significant difference (P>0.05). Renal insufficiency occured in 7 patients in IPHC group (14 %), significantly higher than 4 % of control group (3/79) (P<0.05). All patients could recover within 1-2 mo. Both anastomosis leakage rate and retardation of bowel movement rate of IPHC group were 4 % (2/49), not significantly different from 9 % (7/79) and 0 of control group. CONCLUSION: IPHC is safe and reliable for clinical usage.