BackgroundCytoreductive surgery combined with 'Hyperthermic IntraPEritoneal Chemotherapy’ (HIPEC) represents the only potentially curative treatment available for carcinomatosis secondary to colorectal cancer (CRC), pseudomyxoma peritonei (PMP), malignant peritoneal mesothelioma (MM) and goblet cell carcinoma (GCC). Despite preoperative investigation some patients are excluded perioperatively because of unacceptably massive tumor extent. The data available on the clinical course of these patients are sparse. The aim of this study was to investigate mortality, morbidity and clinical course for patients who were excluded.MethodsThis was a retrospective observational study based on records from 35 patients (21 men, 14 women) treated in a national center (Surgical Department P, Aarhus University Hospital) from June 2006 to August 2011 and excluded from the cytoreductive surgery perioperatively. The study population included patients aged 18 to 70 years with CRC (n = 19), PMP (n = 11), MM (n = 3) or GCC (n = 2). Vital status was obtained by 29 November 2012. Three patients were lost to follow-up.ResultsThe 30-day mortality rate was 0%. Postoperative complications within 30 days occurred in three patients (9.4%). In all, 19 patients (54%) had palliative surgery during exploratory laparotomy. In total, 28 patients (88%) received postoperative palliative chemotherapy. The median survival for CRC and PMP patients was 12.7 (95% CI 4.0 to 21.4) and 26.9 (95% CI 25.7 to 28.1) months, respectively.ConclusionsExploratory laparotomy for intended curative treatment of peritoneal carcinomatosis did not imply major morbidity or mortality for patients excluded from treatment due to advanced stage of disease.

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The purpose of this publication is to describe the success, which you find at Obstetrics and Gynecology - online textbook for medical students - sundhed.dk, an easily accessible, up to date Obstetrics and Gynecology teaching for medical students including international students in the Nordic countries. In 2018, NFOG (the Nordic Federation of Societies of Obstetrics and Gynecology) decided to finance the production of an electronic textbook for medical students by 1,000,000 Danish kr.: Text, illustrations, learning principles to be aligned with the curricula for obstetrics and gynecology in Nordic medical schools (and the needs of GPs and junior doctors outside our specialty, but not trainees in obstetrics and gynecology or midwives). Author fee: none. Availability On the internet, for computer, tablet and smartphone. No paper version published. Based on modern pedagogic principles not addressed in traditional printed books. Free access to the platform (open source). Each chapter written by a set of subspecialist authors from three or more Nordic countries. The editorial committee Included members from each Nordic country (the authors of this publication). Distributed relevant topics among 32 obstetrical and 28 gynecological chapters. Appointed a maximum number of words for each chapter. Enrolled about 187 authors. Electronic platform for publication dk, even though some book companies offer platform with more features. However, sundhed.dk guarantees reliability and offers this service for free. Videos and illustrations We engaged two gynecologists, Jørgen Præst for video editing and Lotte Clevin who is also a professional illustrator. The use of good colleagues ensured the relevance of the products. Formalities We hired a law firm to elaborate collaboration agreements. That was necessary with these international stakeholders. Language revision An obstetrician/gynecologist (Reynir Tómas Geirsson, former AOGS Chief Editor) delivered text editing. Multiple-choice questions A medical student (Thomas Jensen) established a platform for MCQ. Authors, professors, associate professors, and medical students are encouraged to add new MCQ to this collection. We publish them as soon as the authors have approved the suggestion.