ObjectiveTo investigate healing of rat colonic anastomoses after early postoperative intraperitoneal chemotherapy (EPIC).MethodsFortyfive Wistar rats with colonic anastomoses were divided randomly into 3 groups (15 rats each). From postoperative 1 day to 5 day, rats were injected with normal saline (NS) to the peritoneal cavity with 20 ml/(kg·d) for the NS group; 5Fu with 20 mg/(kg·d) for the 5Fu group; 5Fu with 20 mg/(kg·d) and leucovorin with 10 mg/(kg·d) for the 5Fu+LV group. On the 7th postoperative day, rats were killed and the anastomoses were evaluated whether anastomotic complications (leakage or dehiscence) occurred, the anastomotic bursting pressure (ABP) and hydroxypoline content (HPC) were measured. ResultsIn the NS group, 1 rat had incision dehiscence, another one had anastomostic leakage with but no death. In the 5Fu+LV group, 2 rats showed anastomotic leakage and 1 death. On the 7th postoperative day, the ABP in NS, 5Fu and 5Fu+LV groups were (169.1±32.6) mm Hg, (116.8±25.5) mm Hg and (154.9±31.2) mm Hg respectively; the HPC was (1.54±0.28) μg/mg, (0.9±0.33) μg/mg and (1.24±0.29) μg/mg respectively. Both the ABP and HPC, in the NS group were much significantly higher than in 5Fu group (P＜0.01). Both the ABP and HPC in the 5Fu+LV group were significantly higher than which in the 5Fu group (P＜0.05).ConclusionEPIC with 5Fu significantly impairs healing of the colonic anastomosis. 5Fu combined with LV for EPIC might reduce this inhibition to the process of the anastomotic healing.
【摘要】 目的 探讨一次性麻醉穿刺包与普通腹腔穿刺包在腹腔化疗中应用效果。 方法 将2008年6月-2009年4月住院的胃癌和卵巢癌行腹腔化疗的患者53例，随机分为两组。实验组29例，用一次性麻醉穿刺包行腹腔穿刺化疗；对照组24例，用普通腹腔穿刺包行腹腔穿刺化疗；比较两组患者应用不同穿刺包行腹腔穿刺化疗的并发症比较。 结果 实验组并发症发生率明显低于对照组(Plt;0.05)。 结论 一次性麻醉穿刺包应用于腹腔化疗中操作简便、创伤小、并发症少，患者乐于接受等优点，值得在临床上推广使用。【Abstract】 Objective To explore the effects of one-off anesthesia paracentesis kit and ordinary peritoneal paracentesis kit in intraperitoneal chemotherapy. Methods A total of 53 patients with gastric cancer or ovarian cancer from June 2008 to April 2009 were randomly divided into two groups: 29 patients in trial group underwent intra-peritoneal chemotherapy with one-off anesthesia paracentesis kit, and 24 patients in the control group underwent intra-peritoneal chemotherapy with ordinary peritoneal paracentesis kit. The complications in two groups were compared. Results The incidence of complications in trial group was much lower than that in the control group (Plt;0.05). Conclusion One-off anesthesia paracentesis kit in intra-peritoneal chemotherapy has several advantages including simple manipulation, small injuries, and few complications, which is well accepted by the patients.
Objective To explore the feasibility, safety, efficacy and mechanism of intraoperative regional chemotherapy of advanced gastric cancer.Methods The related literatures were reviewed and analyzed. Results Compared with systemic chemotherapy, intraoperative regional chemotherapy of advanced gastric cancer could increase blood drug concentration of cancerous tissue, reduce the systemic toxic side effects, increase survival rate and improve the quality of life. Conclusion Intraoperative regional chemotherapy, as an adjuvant treatment of advanced gastric cancer, has been gradually applied to clinic because of the definite curative effect, which is worth popularizing. However, it needs systemic researches and accumulation of cases.
Objective To study the value of intraperitoneal chemotherapy in the treatment of gastrointestinal malignancies. Methods The current literature on intraperitoneal chemotherapy was reviewed. Results Following intraperitoneal injection, the concentration of drugs in the peritoneum and in the portal vein was high, lasting and sustained. Early postoperative chemotherapy showed better results. Port-A-Cath provides a safe and suitable drug delivery system. Complications were mild. Conclusion Intraperitoneal chemotherapy presents significant pharmacokinetic and clinical potentials in the treatment of gastrointestinal malignancies, as well as in the prevention and treatment of postoperative metastasis.