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PERIOPERATIVE OUTCOMES OF CYTOREDUCTIVE SURGERY AND PERIOPERATIVE INTRAPERITONEAL CHEMOTHERAPY FOR NON‐APPENDICEAL PERITONEAL CARCINOMATOSIS FROM A PROSPECTIVE DATABASE
Author(s) -
Yan T. D.,
Sugarbaker P. H.
Publication year - 2007
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2007.04131_14.x
Subject(s) - medicine , perioperative , peritoneal carcinomatosis , adverse effect , prospective cohort study , surgery , cytoreductive surgery , cancer , ovarian cancer , colorectal cancer
Purpose Cytoreductive surgery and perioperative intraperitoneal chemotherapy has expanded its application in the management of peritoneal carcinomatosis from gastrointestinal and ovarian malignancies. An accurate assessment of perioperative outcomes is crucial for integration of this combined procedure into clinical practice. Methodology A prospective study of 80 patients undergoing the combined treatment for non‐appendiceal peritoneal carcinomatosis was conducted. Forty‐seven adverse events by 8 organ‐systems were rated from Grade I to IV with increasing severity. Grade I morbidity was self‐limiting; Grade II required medical treatments; Grade III required an invasive intervention; and Grade IV required returning to the operating room or intensive care management. Results One patient (1.3%) died postoperatively. Postoperative adverse events affected genitourinary system (38%), haematological system (31%), gastrointestinal system (25%), infection (20%), intravenous catheters status (15%), pulmonary system (14%), cardiovascular system (11%), and neurological system (4%). Thirty‐six patients (45%) experienced 49 Grade III adverse events. Six patients (8%) experienced 8 Grade IV adverse events. More than 4 peritonectomy procedures (p = 0.010), and length of hospital stay of more than 21 days (p = 0.007) were strongly associated with Grade III and/or Grade IV morbidity. Conclusions The morbidity and mortality rates after the combined treatment for non‐appendiceal peritoneal carcinomatosis were within the acceptable range of surgical treatments for other gastrointestinal cancers. A standardized prospective database is required for an accurate assessment of perioperative outcomes.