[Intra-operative pelvic hyperthermochemotherapy combined with surgery in rectal cancer]

In order to prevent local recurrence after curative surgery for rectal cancer, intra-operative pelvic hyperthermochemotherapy (IOPHC) was performed, combined with surgery. Nineteen patients with rectal cancer were given IOPHC (IOPHC group) and 25 patients who underwent curative surgery without IOPHC served as control, in the same period of time. IOPHC was done as follows: After rectal amputation or resection combined with extended lymphadenectomy, the pelvic cavity was filled with a prewarmed perfusate (physiological saline) containing 40 micrograms/ml of MMC. Then, an apparatus for IOPHC we devised was submerged in the perfusate to warm and maintain it at 45 degrees C for 90 minutes. The mean temperature of the esophagus was 37.2 degrees C, so it was not necessary to cool down the body throughout IOPHC. There was no significant postoperative morbidity between the two groups except that the total amount of exudate drained from pelvic cavity was larger in the IOPHC group. Local recurrence occurred in 3 controls, but in only one of the IOPHC group. Thus, IOPHC is a safe and reliable approach to prevent local recurrence of rectal cancer.