Laparoscopic hyperthermic intraperitoneal chemotherapy (CHIPC) in the treatment of malignant ascites
10.3760/cma.j.issn.1007-631X.2010.11.003
- VernacularTitle:腹腔镜辅助持续循环腹腔热灌注化疗治疗恶性腹水
- Author:
Shuzhong GUI
;
Mingchen BA
;
Yunqiang TANG
;
Yinbing WU
;
Bin WANG
;
Hongsheng TANG
- Publication Type:Journal Article
- Keywords:
Laparoscopes;
Peritoneal lavage;
Chemotherapy;
Malignant ascites
- From:
Chinese Journal of General Surgery
2010;25(11):869-872
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate laparoscopic continuous circulatory hyperthermic intraperitoneal chemotherapy (CHIPC) in the treatment of malignant ascites from peritoneal carcinomatosis.Methods From March 2006 to March 2008, 21 patients of malignant ascites secondary to peritoneal carcinomatosis received CHIPC with three courses of treatment for each patient. The first course was performed in operation room under general anesthesia, the second and third were performed in patients ward or intensive care unit (ICU), NS solution of mitomycin-C and cisplatin was delivered by continuous circulatary perfusion into peritoneal cavity at a rate of 500 ml/min for 90 min with an inflow temperature of 43 degrees C. Results Intraoperative course was uneventful in all cases, and mean operative time was (80 ± 18) min. There was no postoperative deaths and severe complications. After treatment patients KPS KPS (Karnofsky,KPS)grades rose from 10-40, with an average rise of (22.2 ± 2.4) (P ＜ 0.01). After laparoscopic CHIPC, clinical complete regression of ascites and related symptoms was achieved in 19 patients, and partial remission achieved in 2 patients. Follow-up was made to all patients until the death which occurred at post laparoscope-assisted CHIPC 1 - 9 months, with a median survival time of 6 months.Two patients who underwent partial remission suffered from port site seeding and tumor metastasis leading to death after treatment at 1 and 2 months respectively. Conclusions Laparoscopy-assisted CHIPC is effective for the treatment of malignant ascites from inoperable peritoneal carcinomatosis and improves the quality of life of these patients.
