Re-admissions for delayed complications after cytoreductive surgery and HIPEC

Area of Science:

• Oncology
• Surgical Oncology
• Gastroenterology

Background:

• Peritoneal metastasis (PM) management involves cytoreductive surgery and hyperthermic intra-peritoneal chemotherapy (CRS + HIPEC).
• Existing data on CRS + HIPEC morbidity and mortality primarily focuses on the immediate postoperative period.
• Late complications occurring after hospital discharge remain under-investigated.

Purpose of the Study:

• To investigate and analyze late post-operative events following CRS + HIPEC.
• To describe complications occurring after patient discharge up to 90 days post-operation.
• To assess the impact of these late complications on patient outcomes.

Main Methods:

• Retrospective analysis of 219 patients who underwent CRS + HIPEC for PM.
• Complications were tracked from hospital discharge to 90 days post-operation.
• Complications were classified using the Clavien-Dindo system.

Main Results:

• 17 patients (7.8%) experienced late complications, with a slightly higher Peritoneal Cancer Index (PCI) noted.
• Readmission averaged 11.7 days, with 29.4% requiring re-operation.
• Mortality was 11.8%, and common complications included abdominal abscesses, ureteral strictures, and enterocutaneous fistulae.

Conclusions:

• Late complications after CRS + HIPEC present a significant concern impacting post-operative quality of life.
• Further research is needed to understand the role of adjuvant chemotherapy in the development of these late complications.
• This study underscores the importance of monitoring patients beyond the immediate postoperative phase.