Sugarbaker Paul H
Program in Peritoneal Surface Malignancies, MedStar Washington Hospital Center, 106 Irving St., NW, Suite 3900, Washington, DC 20010, USA.
Int J Surg Case Rep. 2019;61:309-312. doi: 10.1016/j.ijscr.2019.07.026. Epub 2019 Jul 19.
Peritoneal metastases from gastrointestinal cancer can be treated by a combination of surgery to remove visible evidence of disease and perioperative intraperitoneal chemotherapy to eradicate microscopic disease. Complete cytoreduction is necessary for long-term benefit.
Two sites for incomplete cytoreduction because tumor is hidden from visual inspection were identified. Patients who developed recurrence at these anatomic sites were studied.
A peritoneal tunnel along a patent processus vaginalis allowed tumor to be sequestered along the inguinal canal in a female patient. A peritoneal tunnel beneath a hepatic bridge over the round ligament obscured mucinous tumor in a male patient.
Peritoneal tunnels in the inguinal region or at the porta hepatis should be opened by surgical dissection so that all foci of peritoneal metastases are removed at a complete cytoreductive surgery and these sites treated with chemotherapy.
胃肠道癌的腹膜转移可通过手术切除可见病灶以及围手术期腹腔内化疗以根除微小病灶来进行治疗。为获得长期益处，完全减瘤是必要的。
确定了两个因肿瘤肉眼不可见而导致减瘤不完全的部位。对在这些解剖部位出现复发的患者进行了研究。
一名女性患者中，沿开放的鞘状突形成的腹膜通道使肿瘤沿腹股沟管隐匿。一名男性患者中，肝圆韧带上方肝桥下方的腹膜通道掩盖了黏液性肿瘤。
腹股沟区或肝门处的腹膜通道应通过手术解剖打开，以便在完全减瘤手术中切除所有腹膜转移灶，并对这些部位进行化疗。
