Outcomes of complex abdominal wall reconstruction at the time of CRS and HIPEC
| Autor: | Brigit Baglien, Ledibabari M. Ngaage, Richelle T. Williams, Carly Rosen, Andrea C Bafford, Nader Hanna, Yvonne M. Rasko, Erin M. Rada |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Colorectal cancer Deep vein 030230 surgery Abdominal wall 03 medical and health sciences 0302 clinical medicine medicine Humans Peritoneal Neoplasms business.industry Abdominal Wall Cancer Atrial fibrillation Cytoreduction Surgical Procedures Hyperthermia Induced Middle Aged Plastic Surgery Procedures Prognosis medicine.disease Combined Modality Therapy Thrombosis Surgery Survival Rate medicine.anatomical_structure Oncology Abdominal Neoplasms Chemotherapy Cancer Regional Perfusion 030220 oncology & carcinogenesis Abdomen Female Hyperthermic intraperitoneal chemotherapy Colorectal Neoplasms business Follow-Up Studies |
| Zdroj: | Surgical Oncology. 30:27-32 |
| ISSN: | 0960-7404 |
| DOI: | 10.1016/j.suronc.2019.05.010 |
| Popis: | Introduction Cytoreduction Surgery with Hyperthermic Intraperitoneal Chemotherapy (CRS/HIPEC) is a treatment option for patients with peritoneal metastatic cancer. This procedure has been shown to improve survival, however, patients are often left with abdominal wall and soft tissue defects requiring further surgical correction. We aim to assess the safety and clinical outcomes of abdominal reconstruction performed concurrent with CRS/HIPEC. Methods We conducted a retrospective chart review on patients with peritoneal metastases who received CRS/HIPEC therapy and abdominal wall reconstruction at tertiary center from 2012 to 2018. Records were evaluated for the patient characteristics, oncologic history, operative details, and postoperative course. Complications were graded with the Clavien-Dindo classification. Results Five patients aged 29–54 years old met the inclusion criteria. The most common type of cancer within this cohort was colorectal cancer. To close the abdomen, four patients underwent component release, biologic mesh placement, and primary fascial closure. The last patient was closed with adjacent tissue transfer. Two patients experienced Grade I complications: deep vein thrombosis and leukocytosis (both self-resolved). Three patients experienced Grade II complications: atrial fibrillation, anemia, and a wound infection which required readmission. No patients experienced grades III, IV or V complications. The follow up period was a median of 5.3 months [r: 2.6–21.9 months]. Conclusion The patients benefitted therapeutically from combined abdominal reconstruction and CRS/HIPEC with minimal complications and good long-term survival. We advocate for the coupling of these procedures as the benefits outweigh the risks, and allows wound closure at the time of surgery. |
| Databáze: | OpenAIRE |
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