【摘要】 目的探讨术中及术后早期腹腔热灌注化疗治疗pT₄期结直肠癌患者中的临床效果。方法回顾性分析2014年9月至2015年9月本院收治的136例pT₄期结直肠癌患者临床资料,按照是否进行术中及术后早期腹腔热灌注化疗分为观察组（n=58）及对照组（n=78）。观察组患者在肠癌根治术中及术后早期进行腹腔热灌注化疗,对照组患者单纯施行腹腔镜根治手术,两组术后均给予XELOX方案化疗半年。比较两组手术相关指标、术后并发症及化疗毒副反应的发生情况。结果两组患者均顺利完成腹腔镜手术,无中转开腹病例,无术中死亡病例。两组手术时间、术中出血量、术后首次肛门排气及术后住院时间差异均无统计学意义（均P>0.05）。两组术后切口感染、腹腔积液、肠梗阻、吻合口漏及肺部感染与胸腔积液之和的发生率差异均无统计学意义（均P>0.05）,两组均无因并发症死亡病例。两组胃肠反应、骨髓抑制及肝功能损害发生率差异均无统计学意义（均P>0.05）,观察组在全身化疗期间Ⅰ～Ⅱ度骨髓抑制的发生率高于对照组（P<0.05）。结论 pT₄期结直肠癌患者术中及术后早期进行腹腔热灌注化疗不增加严重化疗毒副反应及术后并发症的发生,安全有效。更多还原

【Abstract】 Objectives To investigate the effectiveness of hyperthermic intraperitoneal chemotherapy during early stage after surgery in patients with pT₄colorectal cancer.Methods This was a retrospective analysis of 136 patients with pT₄colorectal cancer who were treated in our hospital between September 2014 and September 2015.Patients were divided to treatment group（n=58）and control group（n=78）on the basis of whether they received hyperthermic intraperitoneal chemotherapy during surgery to at early postoperative stage.Patients in the treatment group received the above treatment,while those in the control group received in laparoscopic radical surgery.Both groups were given XELOX chemotherapy for six months.Indices related to surgery,postoperative complication,and toxicity related to chemotherapy were compared between the two groups.Results Laparoscopic surgery was uneventful in both groups.There was no conversion to open surgery or death.There was no significant between-group difference in duration of operation,amount of intraoperative blood loss,time to the first anal exhaust and duration of postoperative hospitalization（P>0.05）.Incidence of postoperative infection of incision,peritoneal effusion,intestinal obstruction,anastomotic leakage,pulmonary infection and pleural effusion were similar between the two groups（P>0.05）.There was no death due to complications.There was no significant difference in gastrointestinal reaction,bone marrow suppression and liver function damage between the two groups（P>0.05）.Incidence of Ⅰ-Ⅱ degree bone marrow suppression was higher in the treatment group than in the control group（P<0.05）.Conclusion Hyperthermic intraperitoneal chemotherapy during surgery and at early stage after surgery in patients with pT₄colorectal cancer did not increase risk of severe toxicity due to chemotherapy and complications.It is a safe and effective procedure.更多还原