Chouillard Elie, Ata Toufic, De Jonghe Bernard, Maggiori Léon, Helmy Nada, Coscas Yvan, Outin Hervé
Department of General and Minimally Invasive Surgery, Centre Hospitalier Intercommunal (Poissy Medical Center), 10, rue de Champ Gaillard, 78303 Poissy Cedex, France.
Surg Endosc. 2009 Feb;23(2):363-9. doi: 10.1007/s00464-008-9946-4. Epub 2008 May 7.
Cytoreductive surgery followed by intraperitoneal chemohyperthermia (IPCH) is a promising treatment for patients with peritoneal carcinomatosis, a disease with dismal prognosis.
We describe our preliminary experience with staged adjuvant laparoscopic IPCH after complete resection in patients with locally or regionally advanced colorectal or gastric cancer.
Twenty-one patients underwent resection for colorectal (N = 16) or gastric cancer (N = 5) followed by staged laparoscopic IPCH. No conversion to laparotomy was required. No major operative incident occurred. Mean duration of hospital stay was 12 days (range 9-23 days). No mortality occurred in the 30-day postoperative period. Four patients developed major complications (19%). One patient (5%) was reoperated. Mean follow-up period was 15.5 months (range 9-29 months). Three patients died, including two of cancer-related causes. No patient developed peritoneal carcinomatosis during the follow-up period.
Staged laparoscopic adjuvant IPCH after open or laparoscopic resection in selected patients with colorectal or gastric cancer is feasible and reasonably safe. However, additional data are required to determine the effect on long-term survival.
细胞减灭术联合腹腔内热灌注化疗(IPCH)是一种对腹膜癌患者有前景的治疗方法,该疾病预后不佳。
我们描述了在局部或区域晚期结直肠癌或胃癌患者完全切除术后分期辅助腹腔镜IPCH的初步经验。
21例患者接受了结直肠癌(N = 16)或胃癌(N = 5)切除,随后进行分期腹腔镜IPCH。无需转为开腹手术。未发生重大手术事件。平均住院时间为12天(范围9 - 23天)。术后30天内无死亡病例。4例患者发生了严重并发症(19%)。1例患者(5%)接受了再次手术。平均随访期为15.5个月(范围9 - 29个月)。3例患者死亡,其中2例死于癌症相关原因。随访期间无患者发生腹膜癌。
在选定的结直肠癌或胃癌患者中,开放或腹腔镜切除术后分期腹腔镜辅助IPCH是可行且相对安全的。然而,需要更多数据来确定其对长期生存的影响。