ObjectiveTo investigate healing of rat colonic anastomoses after early postoperative intraperitoneal chemotherapy (EPIC).MethodsFortyfive Wistar rats with colonic anastomoses were divided randomly into 3 groups (15 rats each). From postoperative 1 day to 5 day, rats were injected with normal saline (NS) to the peritoneal cavity with 20 ml/(kg·d) for the NS group; 5Fu with 20 mg/(kg·d) for the 5Fu group; 5Fu with 20 mg/(kg·d) and leucovorin with 10 mg/(kg·d) for the 5Fu+LV group. On the 7th postoperative day, rats were killed and the anastomoses were evaluated whether anastomotic complications (leakage or dehiscence) occurred, the anastomotic bursting pressure (ABP) and hydroxypoline content (HPC) were measured. ResultsIn the NS group, 1 rat had incision dehiscence, another one had anastomostic leakage with but no death. In the 5Fu+LV group, 2 rats showed anastomotic leakage and 1 death. On the 7th postoperative day, the ABP in NS, 5Fu and 5Fu+LV groups were (169.1±32.6) mm Hg, (116.8±25.5) mm Hg and (154.9±31.2) mm Hg respectively; the HPC was (1.54±0.28) μg/mg, (0.9±0.33) μg/mg and (1.24±0.29) μg/mg respectively. Both the ABP and HPC, in the NS group were much significantly higher than in 5Fu group (P＜0.01). Both the ABP and HPC in the 5Fu+LV group were significantly higher than which in the 5Fu group (P＜0.05).ConclusionEPIC with 5Fu significantly impairs healing of the colonic anastomosis. 5Fu combined with LV for EPIC might reduce this inhibition to the process of the anastomotic healing.
Pre-and postoperative perfusion of thermochemotherapy was used in 25 cases of advanced malignant tumors of digestive tract.There were on significant changes in hepatic and renal functions after perfusions.The erythrocyte,leukocyte and platelet counts reduced in the second and third week after the beginningof perfusion,but rose up in the 4th week.A 2-year follow-up revealed that 23 patients were still alive without recurrence or metastases except 2cases died in the 6th and the 9th month after treatment.We claim that intraperitoneal thermochemotherapy is a simple and safe method. A prospective study is still necessaryin deciding the dose and course.
Objective To explore the feasibility, safety, efficacy and mechanism of intraoperative regional chemotherapy of advanced gastric cancer.Methods The related literatures were reviewed and analyzed. Results Compared with systemic chemotherapy, intraoperative regional chemotherapy of advanced gastric cancer could increase blood drug concentration of cancerous tissue, reduce the systemic toxic side effects, increase survival rate and improve the quality of life. Conclusion Intraoperative regional chemotherapy, as an adjuvant treatment of advanced gastric cancer, has been gradually applied to clinic because of the definite curative effect, which is worth popularizing. However, it needs systemic researches and accumulation of cases.
Objective To study the value of intraperitoneal chemotherapy in the treatment of gastrointestinal malignancies. Methods The current literature on intraperitoneal chemotherapy was reviewed. Results Following intraperitoneal injection, the concentration of drugs in the peritoneum and in the portal vein was high, lasting and sustained. Early postoperative chemotherapy showed better results. Port-A-Cath provides a safe and suitable drug delivery system. Complications were mild. Conclusion Intraperitoneal chemotherapy presents significant pharmacokinetic and clinical potentials in the treatment of gastrointestinal malignancies, as well as in the prevention and treatment of postoperative metastasis.