Urological approach for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in a clinical care center

Trujillo, Carlos Gustavo; Domínguez, Carmen Carrillo; Robledo, Daniela; Caicedo, Juan Ignacio; Bravo‐Balado, Alejandra; Cataño, Juan Guillermo; Cortés, Natalia; Parra, Lina M.; Riaño, Wilson; Londoño-Schimmer, Eduardo; Otero, Jorge; Herrera, Gabriel; Arias, Fernando; Plata, Mauricio

doi:10.1080/00015458.2018.1436797

Cited by 2 publications

(5 citation statements)

References 17 publications

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“…On the other hand, intraoperative gross hematuria is supposed to directly reflect the effects of ureter injury. The incidence ratio of gross hematuria was much higher than the incidence ratio of ureter injury reported in previous studies, at 2–7% [ 21 , 22 ]. We think that observation of intraoperative gross hematuria is more suitable for detecting minor ureter injury without urinary stenosis or obstruction compared to the imaging studies used to diagnose ureter injury in previous studies, and thus may be more versatile in clinical practice.…”

Section: Discussioncontrasting

confidence: 57%

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Association of intraoperative gross hematuria with acute kidney injury after cytoreductive surgery

Mitani

Arai

Mitani

et al. 2022

Pleura and Peritoneum

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Objectives Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) has been established in the management of peritoneal carcinomatosis. Although it is still necessary to take adequate measures against major postoperative complications including acute kidney injury (AKI), consensus is lacking on how to assess and stratify risk for patients with postoperative AKI after CRS-HIPEC. The aim of this retrospective cohort study was to investigate the association of intraoperative gross hematuria as a surrogate marker of ureter injury with postoperative AKI incidence. Methods This retrospective cohort study investigated patients without impaired preoperative kidney function who underwent CRS-HIPEC at a single referral center, and evaluated the relationship between intraoperative gross hematuria and incidence of postoperative AKI as defined by the Kidney Disease Improving Global Outcomes practice guidelines. Logistic regression analysis was performed to calculate the odds ratio of intraoperative gross hematuria for AKI, adjusting for confounding factors and other risk factors for AKI. Results We enrolled 185 patients (males, 37%). Twenty-five patients developed intraoperative gross hematuria. Postoperative AKI occurred in 10 (40%) of 25 patients with hematuria and 28 (17.5%) of 160 patients without hematuria. The crude odds ratio for exposure to hematuria was 3.14 (95% confidence interval, 1.30–7.60; p=0.020) for postoperative AKI. Adjusted odds ratio as estimated by multivariate logistic regression was 4.57 (95% confidence interval, 1.55–13.45; p=0.006). Conclusions Intraoperative gross hematuria is significantly associated with postoperative AKI incidence after CRS-HIPEC.

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Section: Discussioncontrasting

confidence: 57%

“…In fact, ureter injury increases risk of postoperative AKI after general surgery in the fields of urology and gynecology [ 19 , 20 ]. Some reports demonstrated intraoperative ureter injury in about 2–7% of patients during CRS-HIPEC [ 21 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

Association of intraoperative gross hematuria with acute kidney injury after cytoreductive surgery

Mitani

Arai

Mitani

et al. 2022

Pleura and Peritoneum

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“…14 In the 103 CRS + HIPEC cases performed by Trujillo et al, urinary tract injury occurred in 7% of the cases, urinary tract infection in 21%, post-renal failure in 4%, urinary fistula in 4% and acute urinary retention in 1%, reporting that they were not negligible but infrequent. 11 Again in the article by Tan et al comparing groups with and without urinary resection and reconstruction, it was reported that groups with and without surgery did not vary and that these procedures did not increase complication rates but only prolonged hospital stay. 12 Berger et al have reported that median length of hospital stay and ICU stay are greater in cases who underwent extreme CRS + HIPEC.…”

Section: Discussionmentioning

confidence: 99%

“…14 In the 103 CRS + HIPEC cases performed by Trujillo et al ., urinary tract injury occurred in 7% of the cases, urinary tract infection in 21%, post-renal failure in 4%, urinary fistula in 4% and acute urinary retention in 1%, reporting that they were not negligible but infrequent. 11…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6][7][8][9][10] CRS + HIPEC has made a major breakthrough in advanced stage cancer therapy in the last 30 years, with morbidity rates reaching nearly 25-41% and mortality rates 0-8% in high-volume centers in selected patient groups (ASA 1-2, ECOG 0-1 and low PCI) in PC. 11 Tan et al have performed urological resection and reconstruction in 21 of 214 CRS cases in their own series and have reported a urological procedure rate of 9.8%. 12 It has also been reported in the literature that there is a need for urological procedures at a mean rate of 7-20%.…”

Section: Discussionmentioning

confidence: 99%

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Clinical features and surgical outcomes of major urological interventions during cytoreductive surgery and hyperthermic intraperitoneal chemotheraphy

Düzgün

Kalın

Sobay

et al. 2020

Therapeutic Advances in Urology

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Background: Urinary system resections and reconstructions are needed in peritoneal carcinomatosis due to abdominal malignancies. The effect of hyperthermic intraperitoneal chemotherapy on these urological procedures after reconstruction remains uncertain. The aim of the study is to evaluate major urological interventions during cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in complex abdominal malignancies with peritoneal carcinomatosis. Methods: Forty-four cases underwent surgical intervention related to the urinary system among 208 cases who underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy because of peritoneal carcinomatosis. Urinary system procedures performed in these patients (radical-partial cystectomy, partial ureter resection ureteroneocystostomy, ureteroureterostomy, nephrectomy) were evaluated in terms of postoperative morbidity–mortality and survival. Results: Urinary system resections were performed during cytoreductive surgery in a total of 44 cases. The mean age was 54 years (20–73). Patients were diagnosed with peritoneal carcinomatosis due to colorectal cancer in 21 (47.8%), ovarian cancer in nine (20.4%), sarcomatosis in five (11.4%), cervical cancer in four (9%) and other cancers (mesothelioma, uterus, breast, gastric) in five (11.4%) cases. Total nephrectomy was performed in three cases and partial nephrectomy in one case. Cystectomy was performed in 21 cases; 16 of these were partial and five were total cystectomies. Ureteroureterocystostomy with double J was performed in four cases and ureteroneocystostomy in 12 cases. While Clavian–Dindo grade 3–4 complications were seen in nine cases (20.4%), three cases (6.8%) became exitus during the first 30-day follow-up. Conclusions: Although urinary system involvements have been regarded as inoperable in the past, we think that with adequate experience radical urinary interventions performed in suitable patients can be carried out with acceptable morbidity and mortality as seen in our series.

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Urological approach for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in a clinical care center

Cited by 2 publications

References 17 publications

Association of intraoperative gross hematuria with acute kidney injury after cytoreductive surgery

Association of intraoperative gross hematuria with acute kidney injury after cytoreductive surgery

Clinical features and surgical outcomes of major urological interventions during cytoreductive surgery and hyperthermic intraperitoneal chemotheraphy

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