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Published on: July 31, 2016
Morbidity and mortality following cytoreductive surgery with hyperthermic intraperitoneal chemotherapy at a tertiary
Uriel Clemente-Gutiérrez1, Adrián Garza-Gangemi1, Gabriela Trejo-Gómez1
1Department of Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, D.F., Mexico.
Background:
Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy increases progression-free and overall survival in patients with peritoneal carcinomatosis of appendicular or colorectal origin. The morbidity associated with this procedure is significant (30-52%). This modality is also routinely used in other peritoneal diseases with improvement of outcome. The aim of this study was to analyze the morbidity and mortality associated with this procedure.
Material & Methods:
Thirteen patients had cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in a period from May 2011 to March 2013 and were followed up prospectively. Demographic, pathologic, and surgical variables were recorded. The Clavien-Dindo classification was used to assess surgical complications. The main outcome variable was 30-day morbidity and mortality. Descriptive statics were used.
Results:
The mean patient age was 52.4 ± 11.1 years. The most common diagnosis was epithelial ovarian cancer (46.2%). Most patients had an adequate preoperative functional status (77% with ECOG 0). Mean hospital stay was 13.5 ± 11.2 days and 2.7 ± 4.2 days in the intensive care unit. Major morbidity (Clavien-Dindo III or IV) observed in this series was 23%, with 0% mortality.
Conclusion:
Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy is a feasible option with acceptable morbidity and mortality for selected patients with peritoneal carcinomatosis in Mexico.
