胃癌根治切除并温热低渗液腹腔灌洗的疗效分析

目的：评价胃癌根治切除并用温热、低渗液或低渗液加洗必泰腹腔灌洗的疗效与适应证。方法：将1986年1月至1995年12月间施行胃癌根治切除术500例患者分成3组。A组：根治术并用43℃蒸馏水4000ml腹腔灌洗10min，共198例；B组：根治术并用43℃蒸馏水4000ml 醋酸洗必泰0.6g，腹腔灌洗4min，共89例；C组：根治术关腹前应用生理盐水4000ml，腹腔清洗4min，共213例。结果：A组与B组疗效相同，二者合在一起计算称灌洗组。各期病例术后1、3年生存率3组间差异无显著意义；全组5年生存率，灌洗组为63.8%，对照组为51.2%。而且有效病例多为灌洗组中期（Ⅱ、ⅢA期）病例。结论：胃癌根治术，关腹前采用本疗法行腹腔灌洗，对Ⅱ期、ⅢA期病例有良好效果。

Curative effect of radical gastrectomy combined with peritoneal lavage with thermal hypoosmotic solution in treatment of gastric cancer

OBJECTIVE: To evaluate the curative effect and indications of radical gastrectomy combined with peritoneal lavage with thermal hypoosmotic solution, double distilled water (DDW) or DDW plus chlorhexidine acetate, in treatment of gastric cancer. METHODS: Five hundred cases of gastric cancer who underwent radical gastrectomy from January 1986 to December 1995 were divided into three groups: group A with 198 cases who underwent radical gastrectomy and peritoneal lavage for 10 minutes with 400 ml of DDW at 43 degrees C, group B, with 89 cases who underwent radical gastrectomy and peritoneal lavage for ten minutes with 4 000 ml of DDW plus 0.6 g chlorhexidine acetate, and group C, with 213 cases who underwent radical gastrectorny and peritoneal lavage for four minutes with 4 000 ml of normal saline at normal temperature as controls. RESULTS: The group A and group B (called lavage group as a whole) had almost the same curative effects. The one-year survival rates and three-year survival rates were similar among the cases in different stages in no matter what group. The five-year survival rate was 63.8% in the lavage group and 51.2% in the control group, most of the cases with a good effect being at the mid-stage (II and III A stages). CONCLUSION: Peritoneal lavage, helpful in killing the exfoliated cancer cells in peritoneal cavity of patients with gastric cancer at II and III A stages, should be conducted in the treatment of gastric cancer by radical gastrectomy before closing the abdomen.