Published in:
01-12-2020 | Rectal Cancer | ASO Author Reflections
ASO Author Reflections: Is CRS/HIPEC an Indication to Divert Rectal Anastomosis?
Authors:
Ekaterina Baron, MD, Vadim Gushchin, MD, FACS, Mary Caitlin King, BS, Armando Sardi, MD, FACS
Published in:
Annals of Surgical Oncology
|
Issue 13/2020
Login to get access
Excerpt
Up to 40% of patients with peritoneal carcinomatosis require rectal removal during cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) to achieve a complete cytoreduction;
1 however, the safest approach of rectal reconstruction in these patients is unclear, as the role of protective ostomy is mostly investigated in classic rectal cancer surgery.
2 While the level of rectal anastomosis performed during CRS/HIPEC is usually higher than in rectal cancer surgery since the main goal is to achieve peritoneal clearance rather than a clear rectal margin with total mesorectum excision, CRS/HIPEC itself might be an unfavorable background for anastomosis due to significant surgical trauma, extended operative time, extensive blood loss, fluid overload, and chemical exposure. Therefore, HIPEC surgeons frequently divert even high rectal anastomoses.
3 …
