Lyon Timothy D, Turner Ii Robert M, Nikonow Tara N, Wang Li, Uy Jamie, Ramalingam Lekshmi, Holtzman Matthew P, Pingpank James F, Bartlett David L, Davies Benjamin J
Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania.
J Surg Oncol. 2016 Feb;113(2):218-22. doi: 10.1002/jso.24115. Epub 2016 Jan 18.
To evaluate whether urologic procedures during cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) are associated with adverse postoperative outcomes.
We identified patients who underwent CRS-HIPEC at our institution from 2001 to 2012 and compared outcomes between operations that did and did not include a urologic procedure.
A total of 938 CRS-HIPEC procedures were performed, 71 of which included a urologic intervention. Urologic interventions were associated with longer operative times (547 vs. 459 min, P < 0.001) and greater length of stay (15 vs. 12 days, P = 0.003). Major complications (Clavien III and IV) were more common in the urologic group (31% vs. 20%, P = 0.028). On multivariable analysis, urologic procedures were associated with a low anterior resection (OR: 2.25, 95%CI 1.07-4.74, P = 0.033) and a greater number of enteric anastomoses (OR: 1.83, 95%CI 1.31-2.56, P < 0.001). At a median follow up of 17 months (IQR 5.6-35 months), addition of a urologic procedure did not significantly impact overall survival for appendiceal or colorectal cancers.
Urologic surgery at the time of CRS-HIPEC is associated with longer operative times, length of stay and increased risk of major complications, but not with decreased overall survival. J. Surg. Oncol. 2016;113:218-222. © 2016 Wiley Periodicals, Inc.
评估减瘤性手术联合热灌注腹腔化疗（CRS-HIPEC）期间的泌尿外科手术是否与术后不良结局相关。
我们确定了2001年至2012年在本机构接受CRS-HIPEC的患者，并比较了包含和不包含泌尿外科手术的手术结局。
共进行了938例CRS-HIPEC手术，其中71例包括泌尿外科干预。泌尿外科干预与更长的手术时间（547分钟对459分钟，P<0.001）和更长的住院时间（15天对12天，P=0.003）相关。主要并发症（Clavien III级和IV级）在泌尿外科组中更常见（31%对20%，P=0.028）。多变量分析显示，泌尿外科手术与低位前切除术（OR：2.25，95%CI 1.07-4.74，P=0.033）和更多的肠吻合术相关（OR：1.83，95%CI 1.31-2.56，P<0.001）。在中位随访17个月（IQR 5.6-35个月）时，增加泌尿外科手术对阑尾癌或结直肠癌的总生存期没有显著影响。
CRS-HIPEC时进行泌尿外科手术与更长的手术时间、住院时间和更高的主要并发症风险相关，但与总生存期降低无关。《外科肿瘤学杂志》2016年；113：218-222。©2016威利期刊公司。
