Arias F, Otero J M, Londoño E, Becerra H, Carvajalino S, Rodríguez C I, Granados J J, Quintero P, Mora M, Castro C, Carranza H, Vargas C, Reyes A, Rojas L, Reveiz L, Cardona A F
Departamento de Cirugía, Fundación Santa Fe de Bogotá, Bogotá DC, Colombia.
Rev Gastroenterol Mex. 2012 Apr-Jun;77(2):66-75. doi: 10.1016/j.rgmx.2012.03.001. Epub 2012 Jun 4.
The procedure of radical peritonectomy followed by hyperthermic intraperitoneal chemotherapy (HIPEC) is considered the standard treatment for peritoneal cancers.
To evaluate various outcomes in a cohort of patients with peritoneal tumors treated with HIPEC.
Twenty-four patients consecutively treated with radical peritonectomy plus HIPEC within the time frame of November 2007 to July 2010 were enrolled; 15 (62%) had tumors of appendicular origin, 4 (16.7%) had primary peritoneal tumors, 2 had ovarian carcinomas and there was one case of colon cancer, one carcinosarcoma and one hemangioendothelioma. Mean age was 53 years (range: 26-68) and median follow-up was 14.2 months (range: 1-32). Demographic data, histology, peritoneal cancer index (PCI), surgical procedure characteristics, recurrence-free survival (RFS), and overall survival (OS) were all evaluated. Short-term morbidity and mortality were also determined.
Complete cytoreduction was achieved in 18 patients (75%). Mean PCI was 15 (<10: 41% and >10: 58%), and the median (range) for surgery duration, length of stay in the Intensive Care Unit, parenteral nutritional support, and hospital stay were 12,5 (7-20) hours, 11,4 (2-74) days, 13,8 (12-65) days, and 29,1 (10-90) days, respectively. One patient (4%) died 6 months after the procedure, due to multiple associated complications. Considerable morbidity was seen in 52% of cases, including thromboembolic events (41%), catheter-related bacteremia (29%), fistulas (29%), and nephrotoxicity (25%). Six patients (25%) recurred after a median of 21 months of RFS.
Cytoreductive surgery plus HIPEC in well-selected patients presenting with tumors that affect the peritoneum is a procedure that can be carried out in Colombia with an adequate safety and effectiveness profile. Mortality was similar to that reported in the international literature.
根治性腹膜切除术联合热灌注化疗（HIPEC）被认为是腹膜癌的标准治疗方法。
评估接受HIPEC治疗的腹膜肿瘤患者队列中的各种结局。
纳入2007年11月至2010年7月期间连续接受根治性腹膜切除术加HIPEC治疗的24例患者；15例（62%）肿瘤起源于阑尾，4例（16.7%）为原发性腹膜肿瘤，2例为卵巢癌，1例为结肠癌、1例为癌肉瘤和1例为血管内皮瘤。平均年龄为53岁（范围：26 - 68岁），中位随访时间为14.2个月（范围：1 - 32个月）。对人口统计学数据、组织学、腹膜癌指数（PCI）、手术操作特征、无复发生存期（RFS）和总生存期（OS）进行了评估。还确定了短期发病率和死亡率。
18例患者（75%）实现了完全细胞减灭。平均PCI为15（<10：41%，>10：58%），手术持续时间、重症监护病房住院时间、肠外营养支持时间和住院时间的中位数（范围）分别为12.5（7 - 20）小时、11.4（2 - 74）天、13.8（12 - 65）天和29.1（10 - 90）天。1例患者（4%）在术后6个月因多种相关并发症死亡。52%的病例出现了明显的并发症，包括血栓栓塞事件（41%）、导管相关菌血症（29%）、瘘管（29%）和肾毒性（25%）。6例患者（25%）在RFS中位时间21个月后复发。
对于精心挑选的患有影响腹膜肿瘤的患者，细胞减灭手术加HIPEC是一种在哥伦比亚可以安全有效实施的手术。死亡率与国际文献报道的相似。
