胃肠道癌根治手术与辅助性化疗的临床应用

目的　探讨胃肠道癌根治手术与辅助性化疗的应用方法 ,提高胃肠道癌的治愈率 ,延长术后生存期。方法　分析辅助性化疗在胃肠道癌手术前的临床应用 ,腹腔内温热灌注化疗在手术中的应用及根治性手术后的辅助性化疗。结果　术前辅助性化疗是当前研究的热点 ,长期、大批患者的对照研究还有待临床工作的总结方能做出客观的评价。温热灌注化疗可作为进展期胃肠道癌术中理想的辅助性化疗 ,对减少术后腹腔内肿瘤复发有一定的临床实用意义。术后腹腔内给药化疗是安全有效的给药途径 ,可有效地控制、杀灭腹腔内脱落的癌细胞或亚临床病灶 ,同时门静脉系统也有较高的药物浓度 ,对预防和治疗肝转移有利。结论　胃肠道癌根治性手术与辅助性化疗在临床上的应用是多学科相互关联的问题。合适的术式应用、足够的切除范围、彻底的区域淋巴结清扫、正确的术前、术中、术后辅助性化疗是改善胃肠道癌预后的重要措施。

Clinical application of radical operation on gastrointestinal cancer and assistant chemotherapy

Objective To studythe applied method of radical operation on gastrointestinal cancer and assistant chemotherapy, improve the cure rate and prolong the survival after operation. Methods Clinical application of assistant chemotherapy for gastrointestinal cancer before and after radical operation and intraoperative cavity themochemotherapy for advanced gastrointestinal cancer during operation was studied. Results Cavity thermochemotherapy was a perfect assistant method to treat advanced gastrointestinal cancer and could reduce the recurrence of the tumor after operation. Postoperative cavity chemotherapy was a safe and effective approach to control or destrov the cancer cells or subclinical focus. At the same time, there was high medicine concentration in portal vein, which could prevent and treat liver metastasis. Conclusions Appropriate operative application, adequate removal range, quite clearing local lymph nodes, and accurate application of assistant chemotherapy were important measures to treat gastrointestinal cancer.