Fried S J, Miller R, Weaver F A, Faddis D
LAC/USC Medical Center, Department of Surgery.
J Extra Corpor Technol. 1993;25(1):22-6.
Perfusion techniques utilizing hyperthermic chemotherapy have been established as a successful modality of therapy for isolated metastatic malignant melanoma. The combination of chemotherapeutic agents (Dactinomycin, thiotepa and Mechlorethamine HCl) given in high doses, not possible systemically, combined with hyperthermia (40-42 degrees C) in an isolated extremity has shown greater tumor regression compared with systemic medication only. Many of the isolated limb perfusion procedures are performed in non-cardiac centers, especially at specialized cancer institutions. This often presents new obstacles for the perfusionist including lack of adequate perfusion equipment and disposables. Other obstacles include unfamiliarity of the operating room staff with the heart-lung machine and inappropriate and/or unsafe handling of the perfusion circuit. In order to overcome these obstacles and enhance safety, portability and effectiveness, the authors have developed an isolated limb perfusion system. The purpose of this study was to compare the parameters of treatment and long term outcomes demonstrated by our system and method, to previously published data. The qualitative comparative analysis was performed between eight treatments with this type of perfusion system and outcome data previously published. It is the authors' conclusion that the portable isolated limb perfusion system achieved all of the required parameters to provide safe and effective treatment for this type of melanoma. No demonstrated variation of the long term clinical results in our patient population was seen when compared to previously published data.
利用热化疗的灌注技术已被确立为孤立性转移性恶性黑色素瘤的一种成功治疗方式。在孤立肢体中给予高剂量化疗药物（放线菌素D、噻替派和盐酸氮芥），这在全身给药时是不可能的，再结合热疗（40 - 42摄氏度），与仅全身用药相比，已显示出更大程度的肿瘤消退。许多孤立肢体灌注手术在非心脏中心进行，尤其是在专门的癌症机构。这常常给灌注师带来新的障碍，包括缺乏足够的灌注设备和一次性用品。其他障碍包括手术室工作人员不熟悉心肺机以及对灌注回路处理不当和/或不安全。为了克服这些障碍并提高安全性、便携性和有效性，作者开发了一种孤立肢体灌注系统。本研究的目的是将我们的系统和方法所展示的治疗参数和长期结果与先前发表的数据进行比较。对使用这种灌注系统的八次治疗与先前发表的结果数据进行了定性比较分析。作者的结论是，便携式孤立肢体灌注系统达到了为这种类型的黑色素瘤提供安全有效治疗所需的所有参数。与先前发表的数据相比，在我们的患者群体中未发现长期临床结果有明显差异。
