| 朱培谦 王梦龙 王志刚 李红浪 朱正明 朱胜昌.直肠癌TME术后低渗5-FU液盆腔持续灌洗的临床研究[J].实用中西医结合临床,2008,(6):1-2 |
| 直肠癌TME术后低渗5-FU液盆腔持续灌洗的临床研究 |
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| DOI： |
| 中文关键词: 直肠肿瘤 外科手术 盆腔 灌洗 |
| 英文关键词: Rectum tumor Surgery Pelvic Lavage |
| 基金项目:江西省卫生厅创新计划项目（课题编号：20031050） |
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| 摘要点击次数: 546 |
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| 中文摘要: |
| 目的：探讨Ⅲ期直肠癌患者TME术后低渗5-FU液盆腔持续灌洗的临床价值。方法：40例Ⅲ期直肠癌患者TME术后第1天开始进行盆腔持续灌洗化疗，连续3d。对照组40例术后不进行盆腔灌洗，仅常规引流。对两组患者手术后并发症及术后局部复发和生存情况进行比较。结果：（1）手术并发症两组间无显著性差异。（2）灌洗组：6例第1天灌洗液离心后检及肿瘤细胞，13例灌洗液中可见细小组织碎片，其中2例组织病理切片可见肿瘤细胞浸润，1例为淋巴结转移，其余组织为血凝块，第2、3天收集灌洗液未检出异常。对照组40例第1、2、3天引流液离心后未检出肿瘤细胞，未见组织碎片引出。（3）治疗组和对照组1年生存率和复发率比较无显著性差异（P >0.05），3、5年生存率两组比较有显著性差异（P <0.05），两组 3、5年复发率有显著差异（P <0.05）。结论：低渗5-FU液盆腔持续灌洗可以降低Ⅲ期直肠癌患者术后复发率，提高生存率，尤其对直肠系膜周边阳性、直肠系膜切除不完整者更有重要意义。该方法操作简便，无不良反应。 |
| 英文摘要: |
| Objective:To evaluate the clinical value of hypotonic 5-FU sustained pelvic lavage on patients with stage Ⅲ rectal cancer undergoing TME surgery. Methods:40 patients with stage Ⅲ rectal cancer undergoing TME surgery were chosen to start sustaine pelvic lavage chemotherapy on the first day ,and repeated for three consecutive days. Other 40 cases in the control group were only given conventional drainage. The post-operative complications , postoperative local recurrence and survival rate of the two groups were compared.Results:(1)There were no significant differences in surgical complications between two groups.(2)In the treatment group, the tumor cells had been detected in lavage fluid which followed by centrifugation in 6 cases on the first day, and small tumor debris had been detected in other 13 cases, of which 2 cases's pathological slices could found tumor cells,and 1 case have lymph node metastasis, others were of the hemagglutinin block. But on the second and third days no abnormal fluid had been detected. In the control group, no tumor cells had been detected and no tumor debris had been found in any patient in three days. (3)There were no significant differences in survival rate and recurrence rate in the first year between two groups(P >0.05), but the differences were obvious in 3,5-years (P <0.05). Conclusion:Hypotonic 5-FU sustained pelvic lavage technique can reduce the recurrence rate and improve survival rates of stage Ⅲ cancer, particularly, it was important for the patients whose surrounding mesorectum is positive or the surgical resection is incomplete. The method is simple, but no adverse reactions. |
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