Clinical features of pulmonary emboli in patients following cytoreductive surgery (peritonectomy) and hyperthermic intraperitoneal chemotherapy (hipec), a single centre experience

Vukadinovic, V.; Chiou, Judy; Morris, David L.

doi:10.1016/j.ejso.2015.01.016

Cited by 21 publications

(17 citation statements)

References 13 publications

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“…Yet, the risk for PE is known to be higher in CRS/HIPEC, compared to other isolated major surgeries. 42 Our results show that the incidence of PE in patients post-CRS/HIPEC was 6.48% at our center (66 of 1019), which was slightly increased since the last study on PE in 2013 (4.4%). 42 This may be due to an active clinical trial at our centre in patients undergoing major surgery, including CRS/HIPEC, where the intervention protocol includes a routine CTPA.…”

Section: Articlementioning

confidence: 49%

“…42 Our results show that the incidence of PE in patients post-CRS/HIPEC was 6.48% at our center (66 of 1019), which was slightly increased since the last study on PE in 2013 (4.4%). 42 This may be due to an active clinical trial at our centre in patients undergoing major surgery, including CRS/HIPEC, where the intervention protocol includes a routine CTPA. This may result in higher detection of PE, especially in patients that are clinically asymptomatic, and as a result increase the incidence at our centre.…”

Section: Articlementioning

confidence: 49%

“…It was reported that PEs following CRS/HIPEC rarely require escalation of care or lead to significant cardio-respiratory dysfunction. 42 As discussed above, we administer prophylactic anticoagulants to all patients undergoing CRS/HIPEC, including post-discharge prophylaxis using low molecular weight heparin (LMWH), and have an aggressive protocol if PE is suspected with CTPA. Yet, the risk for PE is known to be higher in CRS/HIPEC, compared to other isolated major surgeries.…”

Section: Articlementioning

confidence: 99%

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Treatment-related post-operative mortality after cytoreductive surgery and perioperative intraperitoneal chemotherapy

et al. 2017

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Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has an established role in selected patients for the treatment of peritoneal surface malignancy. However, CRS/HIPEC is associated with increased risk of morbidity and mortality. The aim of this review was to identify risk factors for post-operative mortality in an attempt to improve patient outcomes post CRS/HIPEC. This is a retrospective study of prospectively collected data on 1019 patients who underwent CRS/HIPEC by the same surgical team at St George Hospital, Kogarah, Australia, between January 1996 and July 2016.During the 20-year time-period seventeen patients (1.67%) died postoperatively. A higher peritoneal cancer index (PCI), completeness of cytoreduction (CC) score, longer operative time and a volume of intra-operative transfusion were evident in the hospital mortality group and were significantly associated with postoperative mortality on univariate analysis. Postoperative complications including infection, bleeding, pneumonia, fistula, collection and pancreatic leak were also associated with post-operative mortality. The most common cause of death was sepsis (n=15, 88.2%).It is difficult to determine pre-operative factors that can be utilized as predictors of post-operative mortality, as the overall incidence of in-hospital mortality post CRS/HIPEC was very low on our unit. Nevertheless, a cascade of events and learning curve was displayed.

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Section: Articlementioning

confidence: 49%

Section: Articlementioning

confidence: 49%

Section: Articlementioning

confidence: 99%

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Treatment-related post-operative mortality after cytoreductive surgery and perioperative intraperitoneal chemotherapy

et al. 2017

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“…Haematological complications include neutropenia and thrombocytopenia with incidence of it varying because of the practice heterogeneity in the drug used, its dosage, duration and temperature [6]. Other well-defined complications include renal insufficiency (2-4%), venous thromboembolism (4-4.4%), urinary tract infections and vascular access infections [7,8].…”

Section: Discussionmentioning

confidence: 99%

Acute Liver Failure Following Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: A Case Report

Kohli

Penumadu

Subramaniam.

2019

Cureus

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Cytoreductive surgery (CRS) followed by hyperthermic intraperitoneal chemotherapy (HIPEC) is a commonly used one-step modality for peritoneal surface malignancies. Despite the gain in popularity and effectiveness, HIPEC is still associated with significant post-operative morbidity and mortality. Liver failure, following HIPEC surgery, which does not involve major liver resection has not been well defined or reported. Hence, we report a case of liver failure in a 51-year-old lady, with recurrent carcinoma ovary, who underwent cytoreductive surgery followed by HIPEC and the potential multifactorial causes that could have caused it.

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“…None of these studies investigated HIPEC patients. In addition to active cancer, prolonged surgery and immobilization as well as an increase in body temperature during HIPEC all predispose patients to thromboembolic complications [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Hyperthermic intraperitoneal chemotherapy enhances blood coagulation perioperatively evaluated by thromboelastography: a pilot study

Tuovila

Erkinaro

Takala

et al. 2020

International Journal of Hyperthermia

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Background and Objectives: Postoperative thromboembolism is a significant cause of prolonged recovery in patients undergoing cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Thromboelastography (TEG) can detect hypercoagulable states and predict thromboembolic complications after surgery. This study assessed the impact of CRS and HIPEC on TEG values. Methods: TEG parameters reaction time (R), kinetics time (K), angle (a), maximum amplitude (MA), and lysis percent at 60 min (LY60) were determined preoperatively, and at the end of CRS, during HIPEC, and at the end of the operation using blood samples from 15 HIPEC patients. Platelets, P-TT, and aPTT were also determined before and after CRS. Results: A total of 75 samples were analyzed. During CRS, there was a significant reduction in the mean MA (3.06 mm, p ¼ 0.001). The mean P-TT declined by 32% (p < 0.001) and mean platelets by 55 Â 10 9 /L (p < 0.001). During HIPEC, the mean R and K shortened by 1.04 min (p ¼ 0.015) and 0.18 min (p ¼ 0.018), respectively, whereas a increased by 2.48 (p ¼ 0.005). Conclusions: During CRS, both TEG and conventional laboratory tests indicated hypocoagulation. During HIPEC, however, the initiation of coagulation and the kinetics of thrombin formation were accelerated. ARTICLE HISTORY

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Clinical features of pulmonary emboli in patients following cytoreductive surgery (peritonectomy) and hyperthermic intraperitoneal chemotherapy (hipec), a single centre experience

Cited by 21 publications

References 13 publications

Treatment-related post-operative mortality after cytoreductive surgery and perioperative intraperitoneal chemotherapy

Treatment-related post-operative mortality after cytoreductive surgery and perioperative intraperitoneal chemotherapy

Acute Liver Failure Following Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: A Case Report

Hyperthermic intraperitoneal chemotherapy enhances blood coagulation perioperatively evaluated by thromboelastography: a pilot study

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