老年胃癌患者术中氟尿嘧啶胃周注射联合一次性低渗温热腹腔化疗的疗效观察

目的 评价老年胃癌患者根治术中氟尿嘧啶胃周及胃床组织注射联合一次性低渗温热腹腔化疗的疗效.方法 71例Ⅲ期老年胃癌患者在行D2胃癌根治术中,41例（治疗组）在胃周及胃床组织用氟尿嘧啶直接注射联合一次性低渗温热腹腔化疗,38例（对照组）仅用蒸馏水反复冲洗腹腔,未行化疗.比较两组腹腔游离癌细胞检出率及第1、2年术后复发率.结果 治疗组灌洗液中癌细胞检出率为4.88%（2/41）,对照组为23.68（9/38）（P〈0.05）.治疗组术后1、2年复发率为9.76%（4/41）及19.51%（8/41）;对照组分别为31.58%（12/38）及42.11%（16/38）.差异均有统计学意义（均P〈0.05）.结论 氟尿嘧啶胃周及胃床组织直接注射联合一次性低渗温热腹腔化疗简单、安全,能减少腹腔游离癌细胞,降低术后腹腔复发率.

Intraoperative hypotonic peritoneal hyperthermia combined with regional injection of 5-Fluorouracil for elderly gastric cancer

Objective To investigate the efficacy of intraperitoneal hypotonic peritoneal hyperthermia combined with regional injection of 5-Fluorouracil for elderly gastric cancer. Methods Seventy one elderly patients with gastric cancer stage III undergone D2 resection; 41 cases received intraperitoneal hypotonic peritoneal hyperthermia plus perigastric injection of 5-Flu- ououracil （treatment group）, other 38 cases received saline lavage after radical resection （control group）. Exfoliated cancer cells in peritoneal fluid were examined and postoperative recurrence was compared between two groups. Results The positive rate of exfoliated cancer cell in peritoneal fluid was 4.88% （2/41） in the treatment group and 23.68% （9/38） in the control group （P〈 0.05）. The peritoneal or perigastric recurrence rates within 1 and 2 year after operation were 9.76% （4/41）, 19.51% （8/41） in treatment group, while those were 31.58% （12/38） and 42.11% （16/38） in control group （P〈 0.05）. Conclusion Intraoperative hypotonic peritoneal hyperthermia combined with regional injection of 5-Fluorouracil is a safe and effective method for elderly gastric cancer after radical resection.