关键词: 直肠肿瘤, 腹腔灌注, 雷替曲塞, 安全性

Abstract: Objective To investigate the shortterm safety of raltitrexed intraperitoneal perfusion in patients with rectal cancer undergoing laparoscopic Dixon surgery. Methods Totally 175 patients with rectal cancer at the Department of Colorectal Oncological Surgery, Shengjing Hospital of China Medical University were analyzed retrospectively from June 2016 to December 2017. All the patients were divided into raltitrexed intraperitoneal perfusion group (n=89) and saline intraperitoneal perfusion group (n=86) according to whether given raltitrexed intraperitoneal perfusion or not. The hematological indexes of the two groups before operation and 3 days after operation were recorded. The postoperative exhaust time and postoperative drainage volume within 24 hours were calculated. The postoperative complications including anastomotic leakage, peritoneal irritation sign, incision infection and pulmonary infection were evaluated.  Results The surgery was performed successfully in all patients. There were no significant differences in the  sex (χ2=0.000, P=0.990), depth of tumor invasion (χ2=0.003, P=0.956), degree of lymph node metastasis (Z=－0.590, P=0.556), TNM stage (Z=0.081, P=0.936) or pathological type (Z=1.092, P=0.896) between the two groups. There were no significant differences in postoperative exhaust time ［(75.49±3.97) h vs. (74.28±3.46) h, t=0.479, P=0.523］, postoperative drainage volume within 24 hours ［(201.1±54.1) ml vs. (242.8±25.7) ml, t=0.338, P=0.656］, anastomotic leakage (1.1% vs. 2.3%, χ2=0.351, P=0.554), peritoneal irritation sign (1.1% vs. 2.3%, χ2=0.351, P=0.554), incision infection (2.2% vs. 3.5%, χ2=0.243, P=0.622) and pulmonary infection (2.2% vs. 2.3%, χ2=0.001, P=0.972) between the two groups. Additionally, there were no significant differences  in the counts of erythrocytes ［(3.56±0.27)×1012/L vs. (3.63±0.26)×1012/L, t=0.716, P=0.152］, leukocytes ［(7.63±0.20)×109/L vs. (8.24±0.26)×109/L, t=0.176, P=0.872］, blood platelets ［(170.13±20.12)×109/L vs. (180.18±21.03)×109/L, t=0.103, P=0.975］, glutamicpyruvic transaminase ［(13.25±2.31) U/L vs. (13.28±1.46) U/L, t=0.321, P=0.713］, glutamicoxalacetic transaminase ［(16.51±1.28) U/L vs. (16.23±2.03) U/L, t=0.131, P=0.894］ and creatinine ［(77.36±6.49) μmol/L vs. (78.39±6.64) μmol/L, t=0.499, P=0.519］ 3 days after operation between the two groups. Conclusion Raltitrexed intraperitoneal perfusion in Dixon surgery exhibits high safety, and no significant effect on postoperative recovery. It is easy to operate and has good feasibility, which is worthy to be used in clinic.

Key words: Rectal neoplasms, Intraperitoneal perfusion, Raltitrexed, Safty