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KMID : 0371319920430020176
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Journal of the Korean Surgical Society
1992 Volume.43 No. 2 p.176 ~ p.182
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Preliminary Study about the Safety and Effects of Prophylactic Intraperitoneal Hyperthermo-chemotherapeutic Perfusion Combined with Surgery in Far-advanced Stomach Cancers
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김진영
박은섭/박승군/송광재/홍성기/위선복/박길영/정창우/신미경
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Abstract
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It is well known that serosal invasion and lymph node involvement are the most consistent indicators of the extent of disease and ultimate prognosis in cancer of the stomach. Recently long term survival has been made by extensive lymph node
dissection
but serosal invasion followed by peritoneal seeding has been remained as problem.
Since Spratt et al reported intraperitoneal hyperthermic chemotherapy was performed after excision of intraabdominal tumor in 1980, several studies for preventing peritoneal seeding has been reported in Japan. We had reported clinical trials of
intraperitoneal hyperthermic perfusion in intraabdominal cancers with peritoneal metastasis. Now again we report here a prophylactic intraperitoneal hyperthermo-chemotherapeutic perfusion(IHCP) combined with surgical treatment of 12 patients with
stomach cancer above T with or without peritoneal seeding.
After completion of surgery, the patient's peritoneal cavity was filled with 3 liters of 5% lactated Ringer's solution with mitomycin(10 microgram per ml) and then attached to hyperthermic perfusion system which elevated the temperature up to
46℃and
recirculated it.
Cancer cells in the preoperative peritoneal irrigation fluid were positive in two cases but these floating cancer cells were disappeared after IHCP in both cases. All 12 patients are in relatively good health for 6 to 18 months and there has been
no
specific recurrent signs in the CT examinations checked in 6 months after operation.
The patient's postoperative courses were uneventful except one leakage of the gastro-jejunostomy site and one small localized abscess, but nobody were died. These results show that IHCP combined with surgery is a safe, reliable prophylaxis and/or
treatment for the peritoneal metastasis in far-advanced stomach cancers.
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KEYWORD
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