细胞减灭术联合热灌注化疗治疗伴有腹膜转移的结直肠癌术后并发症的现状:一项前瞻性单中心观察性研究

Current status of postoperative morbidity following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for colorectal cancer with peritoneal metastasis: a prospective single-center observational study.

作者信息

Jo Jae Won, Suh Jung Wook, Lee Sung Chul, Namgung Hwan, Park Dong-Guk

机构信息

Department of Surgery, Dankook University College of Medicine, Cheonan, Korea.

出版信息

Ann Surg Treat Res. 2025 Jan;108(1):12-19. doi: 10.4174/astr.2025.108.1.12. Epub 2025 Jan 7.

Abstract

PURPOSE

This study aimed to evaluate current morbidity rates following cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with colorectal cancer and peritoneal metastasis.

METHODS

A total of 42 patients who underwent CRS and HIPEC for colorectal cancer with peritoneal metastasis at a single tertiary referral center between January 2022 and December 2022 were included. Perioperative outcomes and postoperative complications were prospectively assessed.

RESULTS

The mean peritoneal cancer index (PCI) was 16.0. The distribution of PCI scores was as follows: <10, 33.3%; 10-19, 26.2%; and ≥ 20, 40.5%. Completeness of the cytoreduction (CCR) scores were as follows: 57.1% of patients achieved CCR-0, 16.7% achieved CCR-1, 7.1% achieved CCR-2, and 19.0% achieved CCR-3. The mean operation time was 9.1 hours, and the median hospital stay was 17.0 days. Postoperative complications occurred within 30 days in 47.6% of cases and between 30 and 60 days in 11.9% of cases. Reoperation within 30 days was required in 5 cases, and 1 patient died within 30 days. The most common complications were pleural effusion (5 patients), anastomosis site leakage (3 patients), and pneumonia (3 patients). Patients with higher PCI scores were more likely to experience complications (P = 0.038).

CONCLUSION

Although CRS and HIPEC are still associated with high morbidity and mortality compared to other colorectal surgeries, outcomes have improved with increased experience. These results suggest that the procedure is becoming a more acceptable treatment option over time.

摘要

目的

本研究旨在评估结直肠癌伴腹膜转移患者接受细胞减灭术(CRS)和热灌注化疗(HIPEC)后的当前发病率。

方法

纳入2022年1月至2022年12月期间在单一三级转诊中心接受CRS和HIPEC治疗的42例结直肠癌伴腹膜转移患者。前瞻性评估围手术期结局和术后并发症。

结果

平均腹膜癌指数(PCI)为16.0。PCI评分分布如下:<10,33.3%;10 - 19,26.2%;≥20,40.5%。细胞减灭的完全性(CCR)评分如下:57.1%的患者达到CCR - 0,16.7%达到CCR - 1,7.1%达到CCR - 2,19.0%达到CCR - 3。平均手术时间为9.1小时,中位住院时间为17.0天。47.6%的病例在30天内发生术后并发症,11.9%的病例在30至60天内发生。5例患者在30天内需要再次手术,1例患者在30天内死亡。最常见的并发症是胸腔积液(5例)、吻合口漏(3例)和肺炎(3例)。PCI评分较高的患者更易发生并发症(P = 0.038)。

结论

尽管与其他结直肠手术相比,CRS和HIPEC仍与高发病率和死亡率相关,但随着经验的增加,结局有所改善。这些结果表明,随着时间的推移,该手术正成为一种更可接受的治疗选择。

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