OGAWA Shinji TOKYO DENTAL COLLEGE,Ichikawa General Hospital, Dept.of Surg.Assist., 歯学部, 助手 (80224103)
OHMORI Tai TOKYO DENTAL COLLEGE,Ichikawa General Hospital, Dept.of Surg.Assi.Prof., 歯学部, 講師 (00169070)
竹中 能文 東京歯科大学, 市川総合病院外科学講座, 講師 (40129523)
ONO Shigeo TOKYO DENTAL COLLEGE,Ichikawa General Hospital, Dept.of Surg.Asso.Prof., 歯学部, 助教授 (20124943)
TANAKA Toyoharu TOKYO DENTAL COLLEGE,Ichikawa General Hospital, Dept.of Surg.Asso.Prof., 歯学部, 助教授 (80085810)
MASAMURA Shigeru TOKYO DENTAL COLLEGE,Ichikawa General Hospital, Dept.of Surg.Assist., 歯学部, 助手 (40190342)
|Budget Amount *help
¥2,000,000 (Direct Cost : ¥2,000,000)
Fiscal Year 1995 : ¥1,100,000 (Direct Cost : ¥1,100,000)
Fiscal Year 1994 : ¥900,000 (Direct Cost : ¥900,000)
One of the best options to treat pertoneal metastasis is intraperitoneal chemoinfusion. This therapy has not, however, brought satisfactory results, probably due to separation of the peritoneal cavity caused by adhesion, which arises out of laparotomy, cancerous involvement and chemoinfusion itself. To block this separation a silicon-sheet with an infusion pipe, which is designed by us originally for the purpose of preventing irregular intestinal adhesion after polysurgery, was inserted in the peritoneal cavity, and the pipe was connected with a reservoir implanted subcutaneouly for chemoinfusion. After gaining patient's informed consent (IC), a peritoneography with half-diluted Urographin was performed POD14 through the sheet. The contrast medium was observed scattered throughout the peritoneal cavity.
After IC,this therapy was performed with 14 cases of far advanced gastric cencer with marked peritoneal metastasis accompanied by ascites. Ten of them were primary cases, the rest recurr
ed ones after surgery. Four cases underwent gastric resection, two cases gastroenterostomy, and the rest simple laparotomy. At the end of surgery the sheet and reservoir were inserted. CBDCA 100-300mg, VP-16 100-200mg per body was infused through reservoir POD0 or 7, followed by the same infusion once a week for four consecutive weeks, which was counted as one course of treatment. After the one course the patients were discharged from hospital and the same regimen was repeated at out-patient-clinic as possible as it could be done.
Ascites disappeared and general condition became much better with 13 of 14 cases (93%) and twelve of them could go back home. Nine cases died within ten months after surgery, but the rate of their stay at home was 66.7% after this therapy.
It can be concluded that this kind of therapy is quite practical to enable the patients with peritoneal metastasis to go back and atay at home.