Premium
SO10P
CRITICAL ASSESSMENT OF PREOPERATIVE AND OPERATIVE RISK FACTORS FOR COMPLICATIONS AFTER CYTOREDUCTIVE SURGERY AND PERIOPERATIVE INTRAPERITONEAL CHEMOTHERAPY FOR PSEUDOMYXOMA PERITONEI
Author(s) -
Yan T. D.,
Morris D. L.,
Saxena A.
Publication year - 2009
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.1445-2197.2009.04932_10.x
Subject(s) - medicine , pseudomyxoma peritonei , perioperative , multivariate analysis , cytoreductive surgery , surgery , intraperitoneal chemotherapy , univariate analysis , comorbidity , appendix , cancer , paleontology , ovarian cancer , biology
Background: Cytoreductive Surgery (CRS) combined with peri‐operative intraperitoneal chemotherapy (PIC) has demonstrated improved survival in selected patients with pseudomyxoma peritonei (PMP). This treatment modality was associated with relatively high rates of peri‐operative morbidity and mortality in the past. This study evaluates the clinical and treatment‐related risk factors for peri‐operative morbidity and mortality in PMP patients who underwent CRS and PIC. Methods: One hundred and thirty‐six consecutive CRS and PIC procedures for PMP were evaluated. The association of twenty‐four clinical and treatment‐related risk factors with grades III and IV/V morbidity were assessed by univariate and multivariate analysis. Results: The mortality rate was 4%. The grades III and IV morbidity rates were 21% and 23%, respectively. Multivariate analysis showed 2 significant risk factors for grade IV/V morbidity: ASA > 3 (p = 0.008) and an operation length > 10 hours (p < 0.001). Conclusions: Patients with extensive comorbidity who undergo a long cytoreductive procedure are at a particularly high risk of a severe adverse event. Preoperative evaluation of patients is necessary to improve peri‐operative outcome.