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目的探讨腹腔镜胃癌根治术辅助腹腔热灌注化疗对进展期胃癌患者复发率及生存率的影响。方法进展期胃癌患者59例,随机分为对照组29例和观察组30例。对照组行单纯腹腔镜胃癌根治术,观察组于腹腔镜胃癌根治术后给予顺铂+5-氟尿嘧啶腹腔热灌注化疗,术后均给予SOX(奥沙利铂+替吉奥)方案化疗。记录2组术后并发症发生率,随访观察术后1、2、3a复发率和生存率。结果 2组术后均未出现并发症;术后均完成6个周期化疗,无因严重不良反应退出研究病例;术后随访3a,均未失访,观察组术后1、2a复发率(3.3%、10.0%)、生存率(96.7%、90.0%)与对照组[复发率(3.4%、20.7%)、生存率(96.6%、79.3%)]比较差异无统计学意义(P>0.05);术后3a复发率(16.7%)低于对照组(41.4%),术后3a生存率(83.3%)高于对照组(59.6%),差异均有统计学意义(P<0.05)。结论腹腔镜胃癌根治术辅助腹腔热灌注化疗治疗进展期胃癌可有效提高生存率,降低复发率。
Objective To investigate the effect of laparoscopic radical gastrectomy assisted with intraperitoneal hyperthermic perfusion chemotherapy on the recurrence rate and survival rate of patients with advanced gastric cancer. Methods Fifty-nine patients with advanced gastric cancer were randomly divided into control group (n = 29) and observation group (n = 30). The control group was treated with simple laparoscopic radical gastrectomy. In the observation group, intraperitoneal cisplatin plus 5-Fluorouracil was injected intraperitoneally after laparoscopic radical gastrectomy. SOX (oxaliplatin plus tirofiban) regimen was given postoperatively. The incidence of postoperative complications in the two groups were recorded and the recurrence rate and survival rate were observed after operation. Results No postoperative complications were found in both groups. Six cycles of chemotherapy were completed after operation, and no patients were withdrawn due to serious adverse reactions. All cases were followed up for 3 years and no follow-up was observed. There was no significant difference between the survival rate (96.7%, 90.0%) and the control group (3.4%, 20.7%, 96.6%, 79.3% ; The recurrence rate after 3 months (16.7%) was lower than that of the control group (41.4%). The postoperative 3a survival rate was 83.3% higher than that of the control group (59.6%). The difference was statistically significant (P <0.05). Conclusions Laparoscopic radical gastrectomy assisted with intraperitoneal hyperthermic perfusion chemotherapy for advanced gastric cancer can effectively improve the survival rate and reduce the recurrence rate.