Treatment-related post-operative mortality after cytoreductive surgery and perioperative intraperitoneal chemotherapy

Authors

  • Boyoung Kim St George Clinical School, University of New South Wales, New South Wales
  • Nayef Alzahrani St George Hospital and University of New South Wales Department of Surgery, Kogarah, New South Wales, Australia; College of Medicine, Al Imam Mohammad Ibn Saud Islamic University
  • Sarah J. Valle St George Hospital and University of New South Wales Department of Surgery, Kogarah, New South Wales
  • Winston Liauw Cancer Care Centre, St George Hospital, Kogarah, New South Wales
  • David L. Morris St George Hospital and University of New South Wales Department of Surgery, Kogarah, New South Wales

DOI:

https://doi.org/10.4081/joper.2017.65

Keywords:

Cytoreductive surgery, Cytoreductive surgery (CRS), hyperthermic intraperitoneal chemotherapy, hyperthermic intraperitoneal chemotherapy (HIPEC), post-operative mortality

Abstract

Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has an established role in selected patients for the treatment of peritoneal surface malignancy. However, CRS/HIPEC is associated with increased risk of morbidity and mortality. The aim of this review was to identify risk factors for post-operative mortality in an attempt to improve patient outcomes post CRS/HIPEC. This is a retrospective study of prospectively collected data on 1019 patients who underwent CRS/HIPEC by the same surgical team at St George Hospital, Kogarah, Australia, between January 1996 and July 2016. During the 20-year time-period seventeen patients (1.67%) died postoperatively. A higher peritoneal cancer index (PCI), completeness of cytoreduction (CC) score, longer operative time and a volume of intra-operative transfusion were evident in the hospital mortality group and were significantly associated with postoperative mortality on univariate analysis. Postoperative complications including infection, bleeding, pneumonia, fistula, collection and pancreatic leak were also associated with post-operative mortality. The most common cause of death was sepsis (n=15, 88.2%). It is difficult to determine pre-operative factors that can be utilized as predictors of post-operative mortality, as the overall incidence of in-hospital mortality post CRS/HIPEC was very low on our unit. Nevertheless, a cascade of events and learning curve was displayed.

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Published

2017-10-23

How to Cite

1.
Kim B, Alzahrani N, Valle SJ, Liauw W, Morris DL. Treatment-related post-operative mortality after cytoreductive surgery and perioperative intraperitoneal chemotherapy. J Peritoneum [Internet]. 2017 Oct. 23 [cited 2024 Dec. 3];2(3). Available from: https://joper.pagepress.net/index.php/joper/article/view/65

Issue

Vol 2, No 3 (2017)

Section

Original Articles

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