Loungnarath Rasmy, Causeret Sylvain, Bossard Nadine, Faheez Mohamed, Sayag-Beaujard Annie-Claude, Brigand Cécile, Gilly François, Glehen Olivier
Department of Colon and Rectum Surgery, Centre Hospitalier de l'Université de Montréal, Hôpital Saint-Luc, Montréal, Québec, Canada.
Dis Colon Rectum. 2005 Jul;48(7):1372-9. doi: 10.1007/s10350-005-0045-5.
Pseudomyxoma peritonei is a rare disease. Recently, cytoreductive surgery with intraperitoneal hyperthermic chemotherapy has emerged as a promising treatment for this debilitating condition. The aim of this prospective study was to evaluate this treatment strategy.
Twenty-seven patients with pseudomyxoma peritonei who were treated by cytoreductive surgery and intraperitoneal chemohyperthermia between 1997 and 2003 were identified from a prospective database.
Clinical presentation included suspected appendicitis (33 percent), increased abdominal girth (30 percent), and a suspected ovarian mass (26 percent). Twenty-two patients underwent surgery elsewhere before referral. Seventeen complications occurred in 12 patients (44 percent). Six were considered major: three anastomotic leaks, two pleural effusions, and one intra-abdominal abscess. Histologic examination demonstrated Grade 1, 2, and 3 disease in 8 (30 percent), 10 (37 percent), and 9 patients (33 percent), respectively. Pathologic grade showed a significant influence on the complication rate (P = 0 0.008). The actuarial five-year survival was 100 percent for patients with Grade 1 disease, whereas actuarial one-, two-, three-, and five-year survival for Grades 2 and 3 were 100, 80, 64, and 32 percent, respectively (P = 0.008).
Cytoreductive surgery with intraperitoneal hyperthermic chemotherapy is a feasible treatment for pseudomyxoma peritonei. It is associated with acceptable morbidity when performed by an experienced surgical team. Histologic grade is the major determinant of survival.
腹膜假黏液瘤是一种罕见疾病。近年来，细胞减灭术联合腹腔内热灌注化疗已成为治疗这种使人衰弱疾病的一种有前景的方法。这项前瞻性研究的目的是评估这种治疗策略。
从一个前瞻性数据库中确定了1997年至2003年间接受细胞减灭术和腹腔内热化疗的27例腹膜假黏液瘤患者。
临床表现包括疑似阑尾炎（33%）、腹围增加（30%）和疑似卵巢肿块（26%）。22例患者在转诊前曾在其他地方接受过手术。12例患者（44%）发生了17例并发症。6例被认为是严重并发症：3例吻合口漏、2例胸腔积液和1例腹腔内脓肿。组织学检查显示，8例（30%）为1级疾病，10例（37%）为2级疾病，9例（33%）为3级疾病。病理分级对并发症发生率有显著影响（P = 0.008）。1级疾病患者的5年精算生存率为100%，而2级和3级疾病患者的1年、2年、3年和5年精算生存率分别为100%、80%、64%和32%（P = 0.008）。
细胞减灭术联合腹腔内热灌注化疗是治疗腹膜假黏液瘤的一种可行方法。由经验丰富的手术团队实施时，其发病率是可接受的。组织学分级是生存的主要决定因素。
