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伴有腹膜转移的癌症患者接受细胞减灭术和热灌注化疗手术后面临的挑战:临床结局的全面综述

Challenges following CRS and HIPEC surgery in cancer patients with peritoneal metastasis: a comprehensive review of clinical outcomes.

作者信息

Karimi Mehdi, Shirsalimi Niyousha, Sedighi Eshagh

机构信息

Faculty of Medicine, Bogomolets National Medical University (NMU), Kyiv, Ukraine.

Faculty of Medicine, Hamadan University of Medical Science (UMSHA), Hamadan, Iran.

出版信息

Front Surg. 2024 Dec 2;11:1498529. doi: 10.3389/fsurg.2024.1498529. eCollection 2024.

DOI:10.3389/fsurg.2024.1498529
PMID:39687325
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11647005/
Abstract

Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) are a pair of relatively modern therapeutic surgical methods in advanced cancerous patients with peritoneal metastasis (PM). The goal of CRS + HIPEC is treatment or to improve survival outcomes, which are linked to high morbidity side effects and complications, even with their possible advantages. Surgical-related, chemotherapy-related, anesthetic-related, gastrointestinal, organs and systemic complications are the categories into which complications are separated according to frequency, risk factors, and effect on patient outcomes. In this narrative review of the literature, the side effects and complications of HIPEC + CRS in cancer patients with PM are examined. The present knowledge on the incidence, frequency, kinds, and risk factors of acute complications following CRS + HIPEC is summarized in this study. This review emphasizes the need for careful patient selection criteria, precise surgical technique, and thorough intraoperative care to reduce or manage these risks. Moreover, it highlights the need for interdisciplinary collaboration in treating these patients. This study aims to know these complications, improve clinical practice, and guide future studies to increase the safety and efficacy of CRS + HIPEC in treating metastatic colorectal cancer.

摘要

细胞减灭术(CRS)和热灌注化疗(HIPEC)是针对伴有腹膜转移(PM)的晚期癌症患者的一对相对现代的治疗性手术方法。CRS+HIPEC的目标是治疗或改善生存结局,即便其具有潜在优势,但也与高发病率的副作用和并发症相关。手术相关、化疗相关、麻醉相关、胃肠道、器官及全身并发症是根据并发症的发生频率、危险因素及对患者预后的影响而划分的类别。在这篇文献综述中,我们对PM癌症患者接受HIPEC+CRS的副作用及并发症进行了研究。本研究总结了目前关于CRS+HIPEC术后急性并发症的发生率、频率、种类及危险因素的相关知识。本综述强调需要谨慎选择患者标准、采用精确的手术技术及全面的术中护理,以降低或控制这些风险。此外,还强调了在治疗这些患者时跨学科协作的必要性。本研究旨在了解这些并发症,改善临床实践,并指导未来研究,以提高CRS+HIPEC治疗转移性结直肠癌的安全性和有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2bad/11647005/493d49396947/fsurg-11-1498529-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2bad/11647005/4938ab93424a/fsurg-11-1498529-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2bad/11647005/493d49396947/fsurg-11-1498529-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2bad/11647005/4938ab93424a/fsurg-11-1498529-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2bad/11647005/493d49396947/fsurg-11-1498529-g002.jpg

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