Garofalo A, Valle M, Garcia J, Sugarbaker P H
General-Oncological Surgery, Department of Surgery, S. Camillo Hospital, Rome, Italy.
Eur J Surg Oncol. 2006 Aug;32(6):682-5. doi: 10.1016/j.ejso.2006.03.014. Epub 2006 Apr 21.
To report the use of laparoscopic Intraperitoneal Hyperthermic Chemotherapy (LIPHC) in the treatment of malignant ascites.
From September 2001 to December 2003, 14 patients between the age of 56 and 78years were treated. Ascites was from gastric cancer (5 cases), colorectal cancer (3 cases), ovarian cancer (3 cases), breast cancer (2 cases) and peritoneal mesothelioma (1 case). The LIPHC was carried out at 42 degrees C for 90 min with 1.5% dextrose solution as a carrier. Chemotherapy was cisplatin and doxorubicin or mitomycin depending on the type of primary tumor. The drains were left in situ after surgery and removed when perfuse drainage ceased.
Ascites was controlled in all the treated cases. A CT scan performed in follow-up showed a small, clinically undetectable, fluid accumulation in the pelvis of one patient.
This method resulted in benefit for those peritoneal carcinomatosis patients with debilitating malignant ascites who were excluded from cytoreductive surgery. Proficiency in laparoscopic staging procedures and experience in the management of carcinomatosis and intraperitoneal hyperthermic chemotherapy (IPHC) are required for the success of the procedure.
报告腹腔镜腹腔内热化疗（LIPHC）在治疗恶性腹水方面的应用。
2001年9月至2003年12月，对14例年龄在56至78岁之间的患者进行了治疗。腹水分别来自胃癌（5例）、结直肠癌（3例）、卵巢癌（3例）、乳腺癌（2例）和腹膜间皮瘤（1例）。LIPHC在42摄氏度下以1.5%葡萄糖溶液为载体进行90分钟。根据原发性肿瘤的类型，化疗药物为顺铂和阿霉素或丝裂霉素。术后引流管留在原位，当灌注引流停止时拔除。
所有治疗病例的腹水均得到控制。随访时进行的CT扫描显示，一名患者盆腔内有少量临床上无法检测到的积液。
该方法对那些因恶性腹水严重而被排除在肿瘤细胞减灭术之外的腹膜癌患者有益。该手术成功需要熟练掌握腹腔镜分期程序以及腹膜癌和腹腔内热化疗（IPHC）管理方面的经验。
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