Bowel complications in 203 cases of peritoneal surface malignancies treated with peritonectomy and closed-technique intraperitoneal hyperthermic perfusion
| Autor: | Grazia Daniela Oliva, Marcello Deraco, Myriam Favaro, Dario Baratti, Rami Younan, Shigeki Kusamura, Cecilia Gavazzi, Pasqualina Costanzo |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Hyperthermia
Adult Male medicine.medical_specialty Peritoneal surface Colon Hyperthermic perfusion medicine.medical_treatment Anastomosis Colon surgery Peritonectomy Gastrectomy Risk Factors medicine Intestinal Fistula Humans Peritoneal Neoplasms Aged Retrospective Studies Chemotherapy Antibiotics Antineoplastic business.industry Anastomosis Surgical Hyperthermia Induced Middle Aged medicine.disease Combined Modality Therapy Surgery Intestines Intestinal Diseases Oncology Chemotherapy Cancer Regional Perfusion Multivariate Analysis Female Peritoneum business |
| Zdroj: | Annals of surgical oncology. 12(11) |
| ISSN: | 1068-9265 |
| Popis: | Peritonectomy and intraperitoneal hyperthermic perfusion (IPHP) are increasingly used in the management of carcinomatosis of various sites of origin. We analyzed the risk factors for bowel complications with primary anastomoses and the closed technique for IPHP.From 1995 to 2004, 203 consecutive procedures were performed at the National Cancer Institute of Milan. We retrospectively analyzed this series of patients. Treated pathologies included peritoneal mesothelioma; pseudomyxoma peritonei; colorectal, ovarian, or gastric carcinomatosis; and abdominal sarcomatosis. All digestive anastomoses were performed before the IPHP. Only one defunctioning stoma was used.We found a bowel complication rate of 10.8%. The bowel complications:anastomoses ratio was 11.3%. On univariate analysis we found a statistically significant association between bowel complications and the following variables: sex, previous systemic chemotherapy status, number of anastomoses ( fewer than two vs. two or more), duration of the procedure (8.7 vs.or=8.7 hours), and extent of cytoreduction. After multivariate analysis, male sex (odds ratio [OR], 4.2), no previous systemic chemotherapy (OR, 3.5), and duration of the procedureor=8.7 hours (OR, 6.3) were considered independent risk factors for bowel complications.Bowel complications are not increased when primary unprotected anastomoses are performed during peritonectomy and IPHP when the closed technique is used. Male sex, duration of the procedure, and no previous systemic chemotherapy are independent unfavorable risk factors. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink