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[全结肠切除回肠直肠吻合术后家族性息肉病残留直肠息肉的临时保留化疗疗效——1例报告]

[The efficacy of temporary retention chemotherapy of the treatment of polyps in the remnant rectum of familial polyposis after total colectomy and ileorectostomy--a case report].

作者信息

Koyama S, Tatsumura T, Ishizaka S, Miyazaki M, Tsuda M, Sato H, Mori A, Yamamoto K

出版信息

Gan To Kagaku Ryoho. 1987 Apr;14(4):1111-5.

PMID:3032113
Abstract

A case of familial polyposis is reported. The patient was a 24-year-old woman on whom total colectomy followed by ileorectostomy had been performed. However, there were multiple polyps remaining in the remnant rectum. For the treatment of these residual polyps, a new chemotherapeutic method known as Temporary Retention Chemotherapy (TRC), originally devised by us for the treatment of advanced gastric cancer, was applied. A balloon catheter was inserted and fixed into the rectum via the anus for the treatment of the rectal tumors. Through the catheter, high-dose 5-fluorouracil (5-FU) solution was injected into the rectum and retained there for one hour before being discarded. During the therapy, the patient was asked to change her position of recumbency at certain intervals, so that the 5-FU solution could act evenly on the lesions in question. This therapy was repeated twice a week, and followed by routine endoscopic studies. A total dose of 5,700 mg of 5-FU was necessary for obtaining a complete response of the remnant lesions. 6 months later, 4 polyps were found, and TRC was again applied, resulting in disappearance of the polyps again after the therapy. So far, no side-effect have been noted as a result of this therapy. She is currently still alive without any residual polyps, carcinoma or metastasis 6 years after the operation.

摘要

报告了一例家族性息肉病病例。患者为一名24岁女性,已接受全结肠切除术并继而行回肠直肠吻合术。然而,残留直肠内仍有多个息肉。为治疗这些残留息肉,应用了一种我们最初为治疗晚期胃癌而设计的新化疗方法,即临时保留化疗(TRC)。通过肛门插入球囊导管并固定于直肠,以治疗直肠肿瘤。通过导管将高剂量5-氟尿嘧啶(5-FU)溶液注入直肠并保留1小时后排出。治疗期间,要求患者每隔一定时间改变卧位,以便5-FU溶液能均匀作用于相关病变。该治疗每周重复两次,随后进行常规内镜检查。为使残留病变完全缓解,共需5700mg的5-FU。6个月后,发现4个息肉,再次应用TRC,治疗后息肉再次消失。迄今为止,该治疗未出现任何副作用。术后6年,她目前仍然存活,无任何残留息肉、癌症或转移。

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