Department of General and Visceral Surgery, Krankenhaus Barmherzige Brüder, Prüfeninger Strasse 86, 93049, Regensburg, Germany.
Department of Informatics, University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania.
Langenbecks Arch Surg. 2019 Aug;404(5):541-546. doi: 10.1007/s00423-019-01808-8. Epub 2019 Jul 27.
Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have become standard of care for many peritoneal malignancies in selected patients. Nevertheless, this aggressive treatment strategy is associated with significant major morbidity. The aim of the present study is to analyze the re-operation rate and clinical outcome following CRS and HIPEC.
In the present study, prospectively documented data of 474 consecutive patients treated with CRS and HIPEC between February 2011 and December 2015 in a high-volume certified reference center for peritoneal malignancies in Germany have been retrospectively analyzed.
The re-operation rate was 14.5%. The most frequent reasons for revisional surgery were fascial dehiscence, intraabdominal hemorrhage, and anastomotic leak. Most complications occurred between postoperative day 7 and 9. However, postoperative bleeding was more common within the first 5 days after surgery. The overall in-hospital mortality rate was 2.1% for all patients and 10% after revisional surgery.
CRS and HIPEC are associated with an acceptable re-operation rate and low mortality rate. Most frequently, re-operations are performed on 7-9 days after initial surgery due to fascial dehiscence, pancreatitis, or anastomotic leak. Postoperative bleedings are more common within the first 5 days after surgery.
细胞减灭术（CRS）和腹腔内热灌注化疗（HIPEC）已成为许多选定患者腹膜恶性肿瘤的标准治疗方法。然而，这种积极的治疗策略与显著的主要发病率相关。本研究旨在分析 CRS 和 HIPEC 后的再手术率和临床结果。
本研究回顾性分析了 2011 年 2 月至 2015 年 12 月期间在德国一家腹膜恶性肿瘤的大容量认证参考中心接受 CRS 和 HIPEC 治疗的 474 例连续患者的前瞻性记录数据。
再手术率为 14.5%。再次手术最常见的原因是筋膜裂开、腹腔内出血和吻合口漏。大多数并发症发生在术后第 7-9 天。然而，术后出血更常见于手术后的前 5 天。所有患者的总住院死亡率为 2.1%，再次手术后为 10%。
CRS 和 HIPEC 相关的再手术率和死亡率可接受。最常见的是在初次手术后的 7-9 天因筋膜裂开、胰腺炎或吻合口漏而进行再次手术。术后出血更常见于手术后的前 5 天。
