How to treat pleural fluid and ascites?

  At present, the incidence of malignant tumors in China is increasing year by year, and malignant tumors of the digestive system account for 60%;-70%; of all tumor incidence, ranking first, and abdominal and pelvic malignant tumors have become the main diseases threatening human life and health. According to statistics, more than 60%; of gastrointestinal malignancies eventually die from intra-abdominal recurrent metastases. So far, there is no treatment method that can solve the problem of implantation and recurrence after radical surgery for intermediate and advanced abdominal and pelvic malignancies. Adjuvant intravenous chemotherapy is the commonly used method, but the side effects are high and the problem of drug resistance cannot be solved. In 1988, Fujimo first used intraperitoneal hyperthermic perfusion chemotherapy (IPHC) for the treatment of gastric cancer based on intraperitoneal chemotherapy (IPC), which provided a new idea. IPHC is mainly used for the treatment of malignant tumors in the abdominal and pelvic tissues and organs when one or more areas of peritoneal implantation metastases occur by breaking through the plasma membrane surface, and also includes prophylactic perfusion for patients with highly suspicious intraoperative peritoneal implantation cancer. It has the advantages of directly killing cancer cells through thermal effect, enhancing the tumor permeability and cytotoxicity of certain chemotherapeutic drugs, producing heat shock proteins to induce specific immunity in the body, flushing out cancer cells retained in the body cavity, and increasing the dose of drugs without increasing toxicity, etc. Verweal’s research group has conducted studies on advanced colorectal cancer, Yonemura et al. in Japan for gastric cancer, and Deraeo et al. in France for ovarian cancer. The studies of IPHC treatment for ovarian cancer have confirmed the good clinical effect of IPHC in treating malignant tumors.  The purpose of thermal infusion chemotherapy is to directly kill microscopic lesions that cannot be completely removed by surgery and tumor cells shed in ascites, and to reduce the rate of recurrence and metastasis after surgery.  2.Reduce the concentration of systemic chemotherapy drugs and reduce the toxic side effects after chemotherapy.  Principle of intracavitary circulation thermal perfusion Heat can increase the potency of some drugs, such as mitomycin at 43℃ is 40 times higher than 37℃, and platinum preparation can reach the highest potency only at 42℃.  Heat can inhibit the activity of DNA repair enzymes in cancer cells.  Heat can increase the permeability of cell membrane, so that more chemotherapeutic drugs can enter cancer cells, and the depth of action on tissues is 1-2.5 mm. Normal tissues are damaged only at 45 ℃ ± 1 ℃.