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Enhanced postoperative recovery with minimally invasive cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal surface malignancies of gastrointestinal origin.
- Source :
-
Surgical oncology [Surg Oncol] 2020 Jun; Vol. 33, pp. 38-42. Date of Electronic Publication: 2019 Dec 19. - Publication Year :
- 2020
-
Abstract
- Background: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are the treatment of choice for select patients with peritoneal surface malignancies; however, the traditional open approach may be associated with significant morbidity. We evaluated postoperative outcomes with minimally invasive (MI) CRS and HIPEC.<br />Methods: Review of our institutional database identified 47 patients who underwent optimal cytoreduction (CC0 or CC1). Those with a PCI ≤ 15 and primary malignancy of gastrointestinal origin were then selected for subgroup analysis. Multivariable regression was performed to identify factors impacting postoperative outcomes.<br />Results: Demographic data did not significantly differ between open (n = 24) and minimally invasive (n = 9) groups. The MI group had a mean age of 57.34 ± 14.92, BMI of 27.03 ± 4.27, Charlson comorbidity score of 1.78 ± 1.72, and PCI of 5.56 ± 5.08. Mean time to flatus (days) was 2.78 in the MI group and 5.04 in the open group (p < 0.001), and mean length of IV analgesic use (days) was 3.11 in the MI group compared to 6.00 in the open group (p = 0.006). Mean length of stay (days) was 5.11 in the MI group and 8.67 in the open group (p = 0.033). Surgical approach (p = 0.037) and BMI (p = 0.039) were the only factors impacting length of stay.<br />Conclusions: Minimally invasive CRS and HIPEC is an excellent option for low volume peritoneal disease of gastrointestinal origin. A minimally invasive approach yields faster return of bowel function, reduced postoperative analgesia requirements, and shorter hospital stay.<br />Competing Interests: Declaration of competing interest The authors have no commercial interest in the subject of study.<br /> (Copyright © 2019 Elsevier Ltd. All rights reserved.)
- Subjects :
- Adult
Aged
Body Mass Index
Carcinoma secondary
Female
Humans
Laparoscopy
Length of Stay statistics & numerical data
Male
Middle Aged
Peritoneal Neoplasms secondary
Recovery of Function
Carcinoma therapy
Cytoreduction Surgical Procedures methods
Gastrointestinal Neoplasms pathology
Hyperthermic Intraperitoneal Chemotherapy methods
Peritoneal Neoplasms therapy
Postoperative Complications epidemiology
Robotic Surgical Procedures methods
Subjects
Details
- Language :
- English
- ISSN :
- 1879-3320
- Volume :
- 33
- Database :
- MEDLINE
- Journal :
- Surgical oncology
- Publication Type :
- Academic Journal
- Accession number :
- 32561097
- Full Text :
- https://doi.org/10.1016/j.suronc.2019.12.006