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大肠癌术后的复发、转移是直接影响5年存沼率的主要因素。术后的辅助治疗至关重要,腹腔内化疗是一种有效的手段。本文介绍了经腹腔泵行腹腔内化疗的方法、理论基础及合并症的防治,并对有关问题进行了深入的讨论。导致复发的主要原因为:腹腔内游离的癌细胞的种植;手术时标本切缘癌细胞的脱落或手术切断血管、淋巴管时,其内的癌栓随血液、淋巴液溢人腹腔;腹腔内少量残留的癌细胞及微小转移灶造成的复发通过手术来预防是极为困难的。腹腔内化疗充分发挥了化疗药的药代动力学上的优越性,腹腔内药物浓度高、效价维持时间长,是静脉给药所形成的药物浓度的数百倍,并且药物经门静脉吸收,因而对门静脉和肝内癌细胞有较好的疗效。经腹腔泵给药操作简单,腹腔内化疗全身反应较静脉给药少。因此.我们认为腹腔内化疗是以手术为主综合治疗大肠癌的有效手段。
The recurrence and metastasis of colorectal cancer are the main factors directly affecting the rate of urinary excretion within 5 years. Postoperative adjuvant therapy is essential, and intraperitoneal chemotherapy is an effective method. This article describes the method of intraperitoneal chemotherapy by abdominal pump, theoretical basis and the prevention and treatment of complications, and in-depth discussion of the relevant issues. The main causes of recurrence are: the cultivation of cancer cells that are free in the abdominal cavity; when surgical specimens are detached from cancer cells at the cutting edge or surgically cut off blood vessels and lymphatic vessels, the tumor emboli in the abdominal cavity is accompanied by blood and lymph fluid; abdominal cavity; The recurrence caused by a small amount of residual cancer cells and micrometastases is extremely difficult to prevent by surgery. Intraperitoneal chemotherapy gives full play to the superiority of the pharmacokinetics of chemotherapy drugs. The intraperitoneal drug concentration is high and the potency is maintained for a long time. It is several hundred times the concentration of drugs formed by intravenous administration, and drugs are absorbed through the portal vein. Therefore, it has a good effect on portal vein and intrahepatic cancer cells. The intraperitoneal pump administration is simple and the systemic response to intraperitoneal chemotherapy is less than intravenous administration. therefore. We believe that intraperitoneal chemotherapy is an effective method for the treatment of colorectal cancer.