Objective: To evaluate the tolerance and safety of simultaneous intraperitoneal chemotherapy in laparoscopic resection of the rectal /sigmoid colon cancer. Methods: Retrospective analysis was performed in 68 cases of rectal /sigmoid colon cancer treated with laparoscopic resection in our hospital between January 2012 and December 2016. All cases were divided into two groups. Group A (n = 31) were given intraoperative chemotherapy with raltitrexed in laparoscopy, and 37 patients in group B were managed with thermal distilled water irrigation. The two groups were observed on the gastrointestinal symptoms, incidences of abdominal cavity and incision infection, encapsulated effusion, intestinal obstruction and anastomotic leakage, and compared regarding the time of drainage tube removal, spontaneous micturition and recovery of intestinal function after surgery as well as the liver and kidney function, white blood cell (WBC) count and immune cell activity one week before operation and 7 th day following laparoscopy. Results: The two groups were statistically different in the perioperative incidences of nausea, vomiting, abdominal distension and diarrhea (P ＜ 0.05), yet the difference was not significant concerning the incidences abdominal pain, postoperative wound infection, encapsulated effusion, intestinal obstruction, anastomotic leakage, preoperative and postoperative liver and kidney function, WBC count and cellular immune function index as well as the time of drainage tube removal, recovery of spontaneous urination and intestinal function after surgery (all P ＞ 0.05). Conclusion: Intraperitoneal chemotherapy with raltitrexed can be tolerable and safe for patients undergoing laparoscopic resection of the rectal /sigmoid colon carcinoma, and this agent will not add postoperative complications to the patients.%目的:评估腹腔镜直、乙状结肠癌根治术中保留雷替曲塞腹腔化疗的耐受性及安全性.方法: 回顾性分析我院2012年1月～ 2016年12月68例行腹腔镜直、乙状结肠癌根治术 (Dixon术) 病例资料, 所有病例分为2组: A组 (术中保留雷替曲塞腹腔化疗组) 31例行腹腔镜直、乙状结肠癌根治术+术中保留雷替曲塞腹腔化疗; B组 (对照组) 37例行腹腔镜直、乙状结肠癌根治术+术中热蒸馏水灌洗.观察2组术后消化道症状、腹腔及切口感染、包裹性积液、肠梗阻、吻合口瘘发生率.比较术后拔除骶前引流管时间、自主排尿时间及肠道功能恢复时间.术前1周内及术后第7天检测2组患者的肝肾功能、白细胞计数及免疫细胞活性. 结果: 2组围手术期不良反应及并发症中恶心呕吐、腹胀、腹泻发生率比较差异有统计学意义 (P ＜ 0.05); 2组腹痛发生率、术后切口感染、包裹性积液、肠梗阻、吻合口瘘等并发症发生率比较差异无统计学意义 (P ＞ 0.05); 2组术前与术后肝肾功能、白细胞计数及细胞免疫功能指标的差值、术后骶前引流管拔除时间、自主排尿时间、肠蠕动恢复时间比较差异无统计学意义 (P ＞ 0.05). 结论: 腹腔镜直、乙状结肠癌TME术中保留雷替曲塞腹腔化疗具有较好的耐受性和安全性, 未明显增加术后并发症.
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