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Langenbeck's Archives of Surgery

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01-08-2019 | Peritonectomy | Original Article

Re-operations for early postoperative complications after CRS and HIPEC: indication, timing, procedure, and outcome

Authors: Sebastian Blaj, Sebastian Nedelcut, Max Mayr, Hubert Leebmann, Daniel Leucuta, Gabriel Glockzin, Pompiliu Piso

Published in: Langenbeck's Archives of Surgery | Issue 5/2019

Abstract

Purpose

Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have become standard of care for many peritoneal malignancies in selected patients. Nevertheless, this aggressive treatment strategy is associated with significant major morbidity. The aim of the present study is to analyze the re-operation rate and clinical outcome following CRS and HIPEC.

Patients and methods

In the present study, prospectively documented data of 474 consecutive patients treated with CRS and HIPEC between February 2011 and December 2015 in a high-volume certified reference center for peritoneal malignancies in Germany have been retrospectively analyzed.

Results

The re-operation rate was 14.5%. The most frequent reasons for revisional surgery were fascial dehiscence, intraabdominal hemorrhage, and anastomotic leak. Most complications occurred between postoperative day 7 and 9. However, postoperative bleeding was more common within the first 5 days after surgery. The overall in-hospital mortality rate was 2.1% for all patients and 10% after revisional surgery.

Conclusions

CRS and HIPEC are associated with an acceptable re-operation rate and low mortality rate. Most frequently, re-operations are performed on 7–9 days after initial surgery due to fascial dehiscence, pancreatitis, or anastomotic leak. Postoperative bleedings are more common within the first 5 days after surgery.

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Title: Re-operations for early postoperative complications after CRS and HIPEC: indication, timing, procedure, and outcome
Authors: Sebastian Blaj
Sebastian Nedelcut
Max Mayr
Hubert Leebmann
Daniel Leucuta
Gabriel Glockzin
Pompiliu Piso
Publication date: 01-08-2019
Publisher: Springer Berlin Heidelberg
Keywords: Peritonectomy
Splenectomy
Splenectomy
Pancreatitis
Surgical Procedures
Published in: Langenbeck's Archives of Surgery / Issue 5/2019
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-019-01808-8

At a glance: The STEP trials

Springer Medicine

Re-operations for early postoperative complications after CRS and HIPEC: indication, timing, procedure, and outcome

Abstract

Purpose

Patients and methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Patients and methods

Results

Conclusions

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