Department of General Surgery, Te Whatu Ora Waikato, Hamilton, New Zealand.
School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
ANZ J Surg. 2024 Apr;94(4):614-620. doi: 10.1111/ans.18833. Epub 2024 Jan 19.
Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is the standard of care for selected cases of peritoneal surface malignancy. However, due to its morbidity and learning curve, it is only delivered in six centres in Australia and Aotearoa New Zealand (AoNZ). In this study, we report peri-operative morbidity and mortality following CRS/HIPEC at Waikato and Braemar Hospitals, which have treated patients from all regions of AoNZ since 2008.
We retrospectively reviewed a database of all patients undergoing CRS and HIPEC from 01/01/2008 to 01/11/2020 at Waikato and Braemar Hospitals.
Two-hundred and forty procedures were performed for 221 patients with a mean age of 55, including 22 (9.2%) re-do procedures. One hundred and eighty-six cases were European, 32 were Māori, and 16 were Pasifika. There were 152 pseudomyxoma peritonei, 39 colorectal adenocarcinomas, 29 appendiceal cancers, 8 ovarian cancers, 6 peritoneal mesothelioma, and 6 other tumour types. The median PCI was 16. HIPEC was administered to 196 out of 196 CC0/1 cases (100%) and 3 out of 44 CC2/3 cases (6.8%). Fifty-six cases (23.3%) had at least one major complication. There were two mortalities (0.8%) within 30 days. The median length of stay was 11 days. Operative duration was identified as an independent risk factor for major complications. There was considerable variation in the number of referrals from different regions of AoNZ. Over time, a decline in major complication rate is seen with increased case volume.
The Waikato region has achieved favourable short-term outcomes following CRS/HIPEC.
细胞减灭术（CRS）和腹腔内热灌注化疗（HIPEC）是选定的腹膜表面恶性肿瘤病例的标准治疗方法。然而，由于其发病率和学习曲线，它仅在澳大利亚和新西兰（AoNZ）的六个中心提供。在这项研究中，我们报告了自 2008 年以来在怀卡托和布雷马尔医院接受 CRS/HIPEC 治疗的患者的围手术期发病率和死亡率，这些患者来自 AoNZ 的所有地区。
我们回顾性地审查了怀卡托和布雷马尔医院自 2008 年 1 月 1 日至 2020 年 11 月 1 日期间所有接受 CRS 和 HIPEC 治疗的患者的数据库。
221 名患者共进行了 240 次手术，平均年龄为 55 岁，其中 22 例（9.2%）为再次手术。186 例为欧洲人，32 例为毛利人，16 例为太平洋岛民。有 152 例假性黏液瘤，39 例结直肠腺癌，29 例阑尾癌，8 例卵巢癌，6 例腹膜间皮瘤和 6 例其他肿瘤类型。PCI 中位数为 16。196 例 CC0/1 病例（100%）和 44 例 CC2/3 病例中的 3 例（6.8%）接受了 HIPEC。56 例（23.3%）至少有一个主要并发症。30 天内有 2 例死亡（0.8%）。中位住院时间为 11 天。手术时间被确定为主要并发症的独立危险因素。来自不同地区的转诊数量存在很大差异。随着病例数量的增加，主要并发症发生率呈下降趋势。
怀卡托地区在接受 CRS/HIPEC 治疗后取得了良好的短期结果。
