Клінічна хірургія (Oct 2020)
Cytoreductive surgery and hyperthermal intraperitoneal chemoperfusion in colorectal cancer and cancer of ovaries: our experience and perspectives of a new method
Abstract
Objective. Studying of results of the cytoreductive operations and hyperthermal intraperitoneal chemoperfusion application for treatment of canceromatosis in colorectal cancer and ovarian cancer. Materials and methods. In 10 patients, suffering colorectal cancer (6 men and 4 women) were performed peritonectomy, diathermo-ablation of implants, made from visceral peritoneum. Average value of the peritoneal canceromatosis index have constituted 18 (14 - 21). In 11 patients, suffering ovarian cancer, panhisterectomy, peritonectomy, omentectomy, and ablation of the visceral peritoneum implants was conducted. Median value of the peritoneal canceromatosis index was 16 (12 - 20). For hyperthermal intraperitoneal chemoperfusion oxaliplatin was used. Results. Complete and optimal cytoreduction (degree CC0-CC1 in accordance to classification of P. H. Sugarbaker) was achieved in 5 patients, while suboptimal one (degree CC2) - in 10, and nonoptimal (degree CC3) cytoreduction - in 6 patients. Intraoperative complications were absent. Postoperative complications have occurred in 5 (23.8%) patients: the wound infection, persisting ileus, episode of partial ileus. Of 10 patients, suffering colorectal cancer, 5 died in 9-12 mo. One-year barrier have had survived 45.5% patients. Of 11 women-patients, suffering ovarian cancer, 7 died in 6-24 mo. One-year barrier have had survived 36.4% women-patients. Conclusion. In patients, suffering colorectal cancer, the survival median was 12 mo, while in the women-patients, suffering ovarian cancer - 18 mo. Cytoreductive operations and hyperthermal intraperitoneal chemoperfusion constitute perspective method for the survival enhancement in patients, suffering canceromatosis, but only if their selection was organized.
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