Postoperative Pancreatic Fistula After Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: An Update on Incidence, Risk Factors, Management, and Clinical Sequelae in 1,141 Patients
| Autor: | Chahaya Gauci, David L. Morris, Amer Matar, Nayef A. Alzahrani, Mohammad S. Alshahrani, Apoorva Rao, Oliver M. Fisher, Thomas Meares |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty Time Factors Databases Factual medicine.medical_treatment Splenectomy Hyperthermic Intraperitoneal Chemotherapy Risk Assessment Pancreatic Fistula Risk Factors Medicine Humans Peritoneal Neoplasms Retrospective Studies Endoscopic retrograde cholangiopancreatography medicine.diagnostic_test business.industry Incidence (epidemiology) Incidence General Medicine Cytoreduction Surgical Procedures Middle Aged medicine.disease Progression-Free Survival Surgery Oncology Pancreatic fistula Chemotherapy Adjuvant Radiological weapon Peritoneal Cancer Index Hyperthermic intraperitoneal chemotherapy Female New South Wales business Cytoreductive surgery |
| Zdroj: | Anticancer research. 41(11) |
| ISSN: | 1791-7530 |
| Popis: | BACKGROUND/AIM An update on the incidence, risk factors, clinical sequalae, and management of postoperative pancreatic fistula (POPF) following cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). PATIENTS AND METHODS Retrospective analysis of prospectively collected data from the St George CRS/HIPEC database. RESULTS Sixty-five (5.7%) out of 1,141 patients developed a POPF. Patients with POPFs were older, had a higher peritoneal cancer index, longer operation time, and required more units of blood intraoperatively. Splenectomy and distal pancreatectomy were significant risk factors for developing POPFs. While there was no effect on overall long-term survival in POPF patients, they did suffer higher rates of Clavien-Dindo grade 3/4 complications, in-hospital deaths, and longer hospital length of stay. Of the 65 POPF patients, 23 were taken back to theatre, 48 required radiological drains and 7 underwent endoscopic retrograde cholangiopancreatography. CONCLUSION There are multiple risk factors for developing POPFs that are non-modifiable. While POPFs are associated with increased postoperative morbidity, long-term survival does not appear to be affected. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|