Cytoreductive Surgery (CS) with Hyperthermic Intraperitoneal Chemotherapy (HIPEC): Postoperative Evolution, Adverse...

Area of Science:

• Oncology
• Surgical Oncology
• Critical Care Medicine

Background:

• Cytoreductive surgery (CS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are established treatments for peritoneal carcinomatosis, aiming to improve survival.
• However, the procedure is associated with a high incidence of postoperative complications, potentially impacting long-term outcomes.
• Understanding these complications and their risk factors is crucial for optimizing patient management.

Purpose of the Study:

• To evaluate the postoperative evolution and complication rates following CS + HIPEC.
• To identify risk factors associated with adverse outcomes and mortality after CS + HIPEC.
• To assess the impact of perioperative factors, including intraoperative epidural analgesia, on patient survival.

Main Methods:

• Retrospective observational study of patients undergoing CS + HIPEC between 2016 and 2023.
• Collection and analysis of pre-, intra-, and postoperative clinical variables.
• Statistical analysis to identify correlations between perioperative data and postoperative complications, hospital stay, and mortality.

Main Results:

• 62.3% of patients experienced postoperative complications, including renal and respiratory failure, and infections.
• Complications were linked to longer surgery duration, mechanical ventilation, and renal replacement therapies.
• Key mortality risk factors included lower preoperative and postoperative hemoglobin and higher C-reactive protein levels.
• Intraoperative epidural analgesia was a significant protective factor against 12-month mortality.

Conclusions:

• CS + HIPEC results in a substantial rate of postoperative complications.
• While complications are frequent, they did not significantly impact postoperative survival in this cohort.
• Intraoperative epidural analgesia is a critical factor in reducing overall mortality after CS + HIPEC.