Complications of Cytoreductive Surgery and HIPEC

Blakely, Andrew M.; Lee, Byrne

doi:10.1007/978-3-030-28891-4_15

Cited by 2 publications

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“…Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) has become a mainstay of treatment for patients with peritoneal carcinomatosis (PC) secondary to colorectal, appendiceal, ovarian, and primary peritoneal malignancies 1–6 . Complications are common following CRS/HIPEC due to the commonly extensive nature of this procedure, and the dramatic physiologic impact induced by hyperthermic chemotherapy infusion 7,8 . Despite a trend to reduce intravenous fluid (IVF) volume administration in patients undergoing abdominal surgery, 9 patients undergoing CRS/HIPEC patients often experience complex hemodynamic changes and receive increased IVF volumes in the perioperative period 10 .…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3][4][5][6] Complications are common following CRS/HIPEC due to the commonly extensive nature of this procedure, and the dramatic physiologic impact induced by hyperthermic chemotherapy infusion. 7,8 Despite a trend to reduce intravenous fluid (IVF) volume administration in patients undergoing abdominal surgery, 9 patients undergoing CRS/ HIPEC patients often experience complex hemodynamic changes and receive increased IVF volumes in the perioperative period. 10 Enhanced Recovery after Surgery (ERAS) protocols have long been…”

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confidence: 99%

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Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy: Effects of postoperative fluids beyond the first 24 h

Berger,

Sullivan,

Bekhor

et al. 2023

Journal of Surgical Oncology

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Background and ObjectivesThere are no guidelines for intravenous fluid (IVF) administration after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC). This study assessed rates of post‐CRS/HIPEC morbidity according to perioperative IVF administration.MethodsAll patients undergoing CRS/HIPEC March 2007 to June 2018 were reviewed, recording clinicopathologic, operative, and postoperative variables. Patients were divided by peritoneal cancer index (PCI), comparing IVF volumes and types administered intraoperatively and during the first 72 h postoperatively. Optimal IVF rate cutoffs calculated using area under the receiver operating characteristic curves and Youden's index determined associations with complications.ResultsOverall, 185 patients underwent CRS/HIPEC, and 81 (51%) had low PCI (<10) and 77 (49%) had high PCI (≥10). In low‐PCI patients, high IVF rates on postoperative days (POD) #0−2 were associated with higher overall complications: POD#0 (46% vs. 89%, p = 0.001), POD#1 (40% vs. 86%, p < 0.05), and POD#2 (42% vs. 72%, p < 0.05). High IVF rates were associated with respiratory distress (7% vs. 26%, p = 0.02) on POD#0, ileus (14% vs. 47%, p = 0.007) and intensive care unit stay (11% vs. 33%, p = 0.022) on POD#1, and ICU stay (8% vs. 33%, p = 0.003) on POD#2.ConclusionsFor low PCI patients undergoing CRS/HIPEC, higher IVF rates were associated with postoperative complications. Post‐CRS/HIPEC, IVF rates should be limited to prevent morbidity.

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Section: Introductionmentioning

confidence: 99%

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confidence: 99%

Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy: Effects of postoperative fluids beyond the first 24 h

Berger,

Sullivan,

Bekhor

et al. 2023

Journal of Surgical Oncology

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Challenges following CRS and HIPEC surgery in cancer patients with peritoneal metastasis: a comprehensive review of clinical outcomes

Karimi,

Shirsalimi,

Sedighi

2024

Front. Surg.

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Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) are a pair of relatively modern therapeutic surgical methods in advanced cancerous patients with peritoneal metastasis (PM). The goal of CRS + HIPEC is treatment or to improve survival outcomes, which are linked to high morbidity side effects and complications, even with their possible advantages. Surgical-related, chemotherapy-related, anesthetic-related, gastrointestinal, organs and systemic complications are the categories into which complications are separated according to frequency, risk factors, and effect on patient outcomes. In this narrative review of the literature, the side effects and complications of HIPEC + CRS in cancer patients with PM are examined. The present knowledge on the incidence, frequency, kinds, and risk factors of acute complications following CRS + HIPEC is summarized in this study. This review emphasizes the need for careful patient selection criteria, precise surgical technique, and thorough intraoperative care to reduce or manage these risks. Moreover, it highlights the need for interdisciplinary collaboration in treating these patients. This study aims to know these complications, improve clinical practice, and guide future studies to increase the safety and efficacy of CRS + HIPEC in treating metastatic colorectal cancer.

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Complications of Cytoreductive Surgery and HIPEC

Cited by 2 publications

References 49 publications

Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy: Effects of postoperative fluids beyond the first 24 h

Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy: Effects of postoperative fluids beyond the first 24 h

Challenges following CRS and HIPEC surgery in cancer patients with peritoneal metastasis: a comprehensive review of clinical outcomes

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