Fujimoto S, Shrestha R D, Kokubun M, Ohta M, Takahashi M, Kobayashi K, Kiuchi S, Okui K, Miyoshi T, Arimizu N
First Department of Surgery, School of Medicine, Chiba University, Japan.
Ann Surg. 1988 Jul;208(1):36-41. doi: 10.1097/00000658-198807000-00005.
Fifteen patients with far-advanced gastric cancer were given surgical treatment followed by intraperitoneal hyperthermic perfusion (IPHP) with mitomycin C (MMC) and misonidazole (MIS), a thermosensitizing drug. Immediately after extensive resection of the abdominal tumors, a 2-hour IPHP was performed at the inflow temperature of 44.7 to 48.7 C, using equipment designed for treatment of cancerous peritoneal seeding as a closed circuit, and under hypothermic general anesthesia at 30 to 31 C. In nine of the 15 patients with peritoneal seeding and/or ascites, cancerous ascites was absent after this treatment. In all cases, repeated cytologic examinations of the lavage from Douglas's pouch were negative. The postoperative courses were uneventful except for Patients 1 and 10, in whom slight leakage occurred. All patients were discharged and are in good health at the time of this writing, 7.2 +/- 4.6 months after the treatment. The Case 4 Patient recently died in a traffic accident. In all patients, transient hepatic dysfunction and hypoproteinemia occurred after the operation. This extensive surgery combined with IPHP using MMC and MIS was well tolerated and is a safe antitumor treatment for gastric cancer with peritoneal dissemination. Neurotoxicity due to MIS was nil.
15例进展期胃癌患者接受了手术治疗，随后进行腹腔内热灌注（IPHP），灌注丝裂霉素C（MMC）和热敏药物米索硝唑（MIS）。在广泛切除腹部肿瘤后，立即进行2小时的IPHP，流入温度为44.7至48.7℃，使用专为治疗癌性腹膜种植设计的设备作为封闭回路，并在30至31℃的低温全身麻醉下进行。在15例有腹膜种植和/或腹水的患者中，9例经此治疗后癌性腹水消失。所有病例中，Douglas窝灌洗的反复细胞学检查均为阴性。除1号和10号患者出现轻微渗漏外，术后病程平稳。所有患者均已出院，在撰写本文时，即治疗后7.2±4.6个月，身体状况良好。4号病例患者最近死于交通事故。所有患者术后均出现短暂性肝功能障碍和低蛋白血症。这种广泛手术联合使用MMC和MIS的IPHP耐受性良好，是一种治疗伴有腹膜播散的胃癌的安全抗肿瘤治疗方法。MIS所致神经毒性为零。
