临床外科杂志 ›› 2026, Vol. 34 ›› Issue (6): 662-665.doi: 10.3969/j.issn.1005-6483.20250625

• 论著 • 上一篇    下一篇

腹腔镜乙状结肠癌根治术后即刻腹腔热灌注化疗的可行性分析

贺少龙,郑春雷,宁可鹏   

  1. 大兴安岭地区人民医院普外科
  • 收稿日期:2025-06-16 出版日期:2026-08-18 发布日期:2026-08-18
  • 通讯作者: 郑春雷
  • 作者简介:贺少龙,郑春雷,宁可鹏
  • 基金资助:
    齐齐哈尔医学院研究生创新基金项目(QYYCX2023-53)

Feasibility analysis of immediate intraperitoneal hyperthermicperfusionchemotherapy after laparoscopic radical surgery for sigmoid colon cancer

HE Shaolong,ZHENG Chunlei,NING Kepeng   

  1. Department of General Surgery,Heilongjiang,Qiqihar Medical University,Da Xing'anling District People's Hospital
  • Received:2025-06-16 Online:2026-06-20 Published:2026-08-18

摘要: 目的 分析腹腔镜乙状结肠癌根治术(CME)后即刻腹腔热灌注化疗(HIPEC)的可行性。方法 2021年1月~2023年1月收治的乙状结肠癌病人80例,均行CME,根据术后是否联合HIPEC将病人分为两组,观察组40例,采用CME联合术后即刻洛铂HIPEC治疗,对照组40例,采用CME联合静脉化疗。比较两组化疗前、化疗后血常规、肝肾功能及术后恢复指标(排气恢复时间、排便恢复时间、普食恢复时间),统计两组并发症总发生率,随访1年后统计两组复发率。结果 两组化疗前及化疗后白细胞计数(WBC)、血小板计数(PLT)、血红蛋白(HGB)比较差异无统计学意义(P>0.05),与化疗前比较,两组化疗后WBC、PLT升高,HGB则降低,比较差异有统计学意义(P<0.05)。观察组化疗前后门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、血肌酐(Scr)、尿素(BUN)比较,差异无统计学意义(P>0.05),对照组化疗前后肝肾功能指标比较,差异无统计学意义(P>0.05);化疗前两组肝肾功能指标比较及化疗后两组肝肾功能指标比较,差异无统计学意义(P>0.05)。观察组排气恢复时间、排便恢复时间、普食恢复时间分别为(3.62±0.71)天、(4.11±0.56)天、(3.86±0.72)天,对照组分别为(4.24±0.80)天、(5.16±0.72)天、(4.64±0.66)天,两组比较有统计学意义(P<0.05)。两组并发症总发生率比较,差异无统计学意义(P>0.05)。随访1年,两组复发病人分别为2例(5.00%)、8例(20.00%),观察组低于对照组,两组比较差异有统计学意义(P<0.05)。结论 CME联合术后即刻HIPEC治疗乙状结肠癌对病人血常规、肝肾功能影响较小,能有效促进病人胃肠功能恢复,降低病人术后复发率,安全性好。

关键词: 乙状结肠癌; 腹腔热灌注化疗; 腹腔镜乙状结肠癌根治术; 洛铂

Abstract: Objective To analyze the feasibility of immediate intraperitoneal hyperperfusion chemotherapy (HIPEC) after laparoscopic radical resection of sigmoid carcinoma. Methods Selecting 80 patients with sigmoid colon cancer admitted to the Second Affiliated Hospital of Qiqihar Medical College from January 2021 to January 2023 as the research subjects,all patients underwent laparoscopic radical resection of sigmoid colon cancer (CME).The patients were divided into two groups according to whether they were combined with HIPEC after surgery.Observation group (40 cases) received CME combined with loplatin HIPEC immediately after surgery.The control group (40 cases) received CME combined with intravenous chemotherapy.Blood routine indexes before and after chemotherapy were compared between the two groups ,liver and kidney function indexes and Postoperative recovery indicators (exhaust recovery time,defecation recovery time,general food recovery time) The total complication rate of the two groups was analyzed,and the recurrence rate in the two groups was analyzed after 1 year follow-up. Results There was no significant difference in white blood cell count (WBC),platelet count (PLT) and hemoglobin (HGB) between the observation group and the control group before and after chemotherapy (P>0.05).Compared with before chemotherapy,WBC and PLT levels were increased after chemotherapy,while HGB levels were decreased (P<0.05).There were no statistically significant differences in Aspartate aminotransferase(AST),alanine aminotransferase(ALT),serum creatinine (Scr) and urea (BUN)) between the observation group and the control group before and after chemotherapy (P>0.05).There were no significant differences in liver and kidney function indexes between the observation group and the control group before and after chemotherapy (P>0.05).The recovery times of exhaust gas, defecation and normal diet in the observation group were (3.62±0.71) days, (4.11±0.56) days and (3.86±0.72) days respectively, while those in the control group were (4.24±0.80) days, (5.16±0.72) days and (4.64±0.66) days respectively. The comparison between the two groups was statistically significant (P < 0.05).There was no statistically significant difference in the total incidence of complications between the observation group and the control group (P>0.05).During the 1-year follow-up,the number of relapsed patients in the observation group and the control group was 2 (5.00%) and 8 (20.00%) respectively.The recurrence rate in the observation group was lower than that in the control group (P<0.05). Conclusion CME combined with immediate postoperative HIPEC in the treatment of patients with sigmoid colon cancer has a relatively small impact on blood routine indicators and liver and kidney function indicators.It can effectively promote the recovery of gastrointestinal function in patients,reduce the postoperative recurrence rate of patients,and has good safety.

Key words: sigmoid cancer; intraperitoneal thermoperfusion chemotherapy; laparoscopic radical resection of sigmoid carcinoma; lobaplatin

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