Shimizu T, Maeta M, Koga S
First Department of Surgery, Tottori University School of Medicine, Yonago, Japan.
Br J Surg. 1991 Jan;78(1):57-9. doi: 10.1002/bjs.1800780119.
Peritoneal hyperthermia may have a role in limiting serosal metastatic disease. When applied to the peritoneal cavity immediately after surgery, it is important to know the optimum temperature, and to investigate the subsequent healing of intestinal anastomoses. To study the first problem, local hyperthermia was applied to the intestinal loop of rats for 30 min. Treatment at 46.0 degrees C or 45.0 degrees C resulted in 100 per cent and 90 per cent mortality respectively, but 100 per cent survival was obtained at 44.0 degrees C. To study the second problem rats with intestinal anastomoses were studied in three groups: group A, local hyperthermia (44.0 degrees C x 30 min) applied to the intestinal loop containing the anastomosis; group B, local hyperthermia (44.0 degrees C x 30 min) applied using saline supplemented with mytomycin C (10 mg/l); group C (controls) no thermal treatment was applied. Anastomotic healing was assessed by breaking strength and histological examination. On the third day after operation, the breaking strength of anastomoses decreased to the lowest values in each group, but no statistically significant differences were noted. On the seventh and 14th day, increased resistance to breaking developed in all three groups and was greatest in the thermally treated groups. Histological findings supported these results. Local hyperthermia up to 44.0 degrees C x 30 min had no adverse effects on the healing of intestinal anastomoses.
腹腔热疗可能在限制浆膜转移性疾病方面发挥作用。在手术后立即应用于腹腔时，了解最佳温度并研究肠道吻合口的后续愈合情况很重要。为研究第一个问题，对大鼠肠袢进行局部热疗30分钟。46.0℃或45.0℃治疗分别导致100%和90%的死亡率，但在44.0℃时获得100%的存活率。为研究第二个问题，将有肠道吻合口的大鼠分为三组：A组，对含有吻合口的肠袢进行局部热疗（44.0℃×30分钟）；B组，使用补充有丝裂霉素C（10mg/l）的盐水进行局部热疗（44.0℃×30分钟）；C组（对照组）不进行热疗。通过抗张强度和组织学检查评估吻合口愈合情况。术后第三天，每组吻合口的抗张强度降至最低值，但未观察到统计学上的显著差异。在第七天和第十四天，三组的抗张强度均增加，且在热疗组中最大。组织学结果支持这些结果。高达44.0℃×30分钟的局部热疗对肠道吻合口的愈合没有不利影响。
