CAJ | 학술논문

目的探讨局部进展期胃癌术中腹腔热灌注化疗的安全性和有效性.方法分析新乡医学院附属南阳市中心医院普外科自2010年5月至2011年5月收治的91例接受标准的D2根治性胃癌切除术的局部进展期胃癌患者的临床资料,按入组顺序根据随机数字表法随机分配到试验组和对照组,其中术中行腹腔热灌注化疗者45例(试验组),术中仅行常规腹腔冲洗者46例(对照组),两组患者均于术后3～4周后按mFOLFOX6方案行全身静脉化疗,比较两组术后并发症发生率、局部复发率和总生存率.结果试验组患者术后肠梗阻发生率低于对照组,差异有统计学意义(x2=3.898,P＜0.05).试验组患者术后吻合口瘘、腹腔感染及肺部感染发生率与对照组相比差异均无统计学意义(x2=0.668、0.501、0.132,均P＞0.05).试验组的1年复发率和总生存率与对照组相比差异均无统计学意义(x2=0.733、0.501,均P＞0.05),试验组3年复发率低于对照组,而生存率高于对照组,差异均有统计学意义(x2=4.847、4.452,P＜0.05).结论对局部进展期胃癌患者行术中腹腔热灌注化疗可降低3年局部复发率,提高3年生存率.
목적 탐토국부진전기위암술중복강열관주화료적안전성화유효성.방법 분석신향의학원부속남양시중심의원보외과자2010년5월지2011년5월수치적91례접수표준적D2근치성위암절제술적국부진전기위암환자적림상자료,안입조순서근거수궤수자표법수궤분배도시험조화대조조,기중술중행복강열관주화료자45례(시험조),술중부행상규복강충세자46례(대조조),량조환자균우술후3～4주후안mFOLFOX6방안행전신정맥화료,비교량조술후병발증발생솔、국부복발솔화총생존솔.결과 시험조환자술후장경조발생솔저우대조조,차이유통계학의의(x2=3.898,P＜0.05).시험조환자술후문합구루、복강감염급폐부감염발생솔여대조조상비차이균무통계학의의(x2=0.668、0.501、0.132,균P＞0.05).시험조적1년복발솔화총생존솔여대조조상비차이균무통계학의의(x2=0.733、0.501,균P＞0.05),시험조3년복발솔저우대조조,이생존솔고우대조조,차이균유통계학의의(x2=4.847、4.452,P＜0.05).결론 대국부진전기위암환자행술중복강열관주화료가강저3년국부복발솔,제고3년생존솔.
Objective To investigate the efficacy and safety of hyperthermic intraperitoneal chemotherapy in the treatment of locally advanced gastric cancer.Methods Clinical data of 91 patients with locally advanced gastric cancer receiving radical D2 gastretomy from May 2010 to May 2012 were retrospectively analyzed.Patients in treatment group underwent intraoperative hyperthermic intraperitoneal chemotherapy (n =45).Systemic chemotherapy with mFOLFOX6 was started after 5 weeks in both treatment and control group (n =46).The overall effective rate,postoperative complications,local carcinoma recurrence and overall survival were compared between two groups.Results The incidence rate of postoperative intestinal obstruction was lower in treatment group than in control group (x2 =3.898,P ＜ 0.05),while there were not statistical differences in anastomotic leakage abdominal infection and pulmonary infection between the two groups (x2 =0.668,0.501,0.132,all P ＞0.05);The recurrence rate of 1-year and overall survival rate were all in favour of treatment group than in control group,though the difference was not significant (x2 =0.733,0.501,all P ＞ 0.05),the 3-year recurrence rate was lower and survival rate was higher in treatment group than in the control group (x2 =4.847,4.452,P ＜ 0.05).Conclusions Intraoperative hyperthermic intraperitoneal chemotherapy helps decrease 3-year local carcinoma recurrence and prolong 3-year overall survival.