Li X B, Ma R, Ji Z H, Lin Y L, Zhang J, Yang Z R, Chen L F, Yan F C, Li Y
Department of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.
Department of Blood Transfusion, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.
Zhonghua Zhong Liu Za Zhi. 2020 May 23;42(5):419-424. doi: 10.3760/cma.j.cn112152-112152-20190430-00278.
This study was to investigate the perioperative safety of cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) for pseudomyxoma peritonei (PMP), and analyze the risk factors of serious adverse events (SAEs). The occurrences of perioperative SAEs were retrospectively analyzed in 254 PMP patients treated with CRS plus HIPEC. Univariate and multivariate analysis were performed to identify independent risk factors. Among the 272 CRS plus HIPEC procedures for 254 PMP patients, a total of 93 (34.2%) perioperative SAEs occurred, including 26 in infection, 22 in digestive system, 17 in respiratory system, 15 in cardiovascular system, 8 in hematological system, and 4 in urinary system. In terms of severity, the vast majority was grade Ⅲ with 76 cases, followed by grade Ⅳ with 13 cases and grade Ⅴ with 4 cases. Univariate analysis revealed 3 risk factors of perioperative SAEs: HIPEC regimen (=0.020), intraoperative red blood cell transfusion volume (=0.004), and intraoperative blood loss volume (=0.002). Multivariate analysis by logistic regression model analysis revealed that intraoperative red blood cell transfusion volume was an independent risk factor for perioperative SAEs (=1.160, =0.001). In conclusion, the perioperative safety of CRS plus HIPEC was acceptable. Moreover, intraoperative blood loss volume and red blood cell transfusion volume are expected to be reduced in order to prevent SAEs for PMP patients.
本研究旨在探讨减瘤手术（CRS）联合热灌注化疗（HIPEC）治疗腹膜假黏液瘤（PMP）的围手术期安全性，并分析严重不良事件（SAEs）的危险因素。回顾性分析254例接受CRS联合HIPEC治疗的PMP患者围手术期SAEs的发生情况。进行单因素和多因素分析以确定独立危险因素。在针对254例PMP患者的272例CRS联合HIPEC手术中，共发生93例（34.2%）围手术期SAEs，其中感染26例、消化系统22例、呼吸系统17例、心血管系统15例、血液系统8例、泌尿系统4例。在严重程度方面，绝大多数为Ⅲ级，共76例，其次是Ⅳ级，共13例，Ⅴ级4例。单因素分析显示围手术期SAEs的3个危险因素：HIPEC方案（=0.020）、术中红细胞输注量（=0.004）和术中失血量（=0.002）。通过逻辑回归模型分析进行的多因素分析显示，术中红细胞输注量是围手术期SAEs的独立危险因素（=1.160，=0.001）。总之，CRS联合HIPEC的围手术期安全性是可以接受的。此外，为预防PMP患者发生SAEs，有望减少术中失血量和红细胞输注量。
