低位直肠癌术中区域应用氟尿嘧啶缓释剂的疗效观察

目的探讨低位直肠癌术中植入氟尿嘧啶缓释剂的可行性和临床疗效。方法根治术术中局部氟尿嘧啶缓释剂将75例低位直肠癌患者随机分成两组,治疗组35例,采用直肠癌根治术同期于盆腔内可能有淋巴转移的区域和可疑亚临床肿瘤病灶区域植入氟尿嘧啶缓释剂,对照组40例,常规行直肠癌根治术,术中仅以氟尿嘧啶液浸泡腹腔。观察对比两组临床疗效。结果治疗组术后无局部复发病例,2例术后2个月并发肿瘤肝转移而死亡;对照组吻合口肠段和盆侧壁肿瘤局部复发分别为2例和4例,术后6～10个月并发肿瘤肝转移6例,广泛腹膜转移3例,8例最终因肿瘤复发和远处转移而死亡。两组比较,治疗组在局部复发率和远处转移率均优于对照组,差异有统计学意义;生存率差异无统计学意义。结论术中区域植入氟尿嘧啶缓释剂疗效显著,降低了局部复发率和远处转移率,可望提高低位直肠癌根治术后的疗效。

Observation of intraperitoneal interstitial implant with sustained-release fluorouracil during operation for carcinoma of the rectum

Objective To investigate the therapeutic effectiveness of intraperitoneal interstitial implant with sustained-release fluorouracil during operation for carcinoma of the rectum. Methods Implanting sustained-release fluorouracil to the metastasis or suspicious focus region during the radical resection of rectal carcinoma.Results In the treated group there were no partial recurrence cases and 2 cases were died of Liver metastasis. In the control group there were 4 tumor recurrence cases of anastomotic and 2 tumor recurrence cases of pelvic wall. After 6~10 months in the control group there were 6 case of liver metastasis and 3 case of peritoneal metastasis. And 8 cases were died of tumor recurrence and distant metastasis in the control group. Comparing the therapeutic effectiveness of the two groups,the treated group were better than the control group in the partial recurrence and the distant metastasis rate.But the two groups has no division in the survival rate.Conclusion The therapeutic effectiveness of intraperitoneal interstitial implant with sustained-release fluorouracil during operation are significant. Also the method can reduce the rate of partial recurrence and distant metastasis to improve the therapeutic effectiveness.