Prognostic factors associated with severe complications after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

Year 2023, Volume: 40 Issue: 4, 768 - 774, 03.01.2024

Huseyin Kemal Raşa , Ayhan Erdemir , Koray Topgül

Abstract

Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) can significantly improve outcomes in certain peritoneal carcinomatosis patient groups but it is a complicated surgical procedure with high morbidity and mortality rates. Our study evaluated the preoperative and perioperative variables to understand whether any variable was associated with an increased risk of complications. We retrospectively evaluated thirty-three successive patients who underwent CRS and HIPEC between 2017 and 2020. Patients were assigned into Group 1 (15 patients) and Group 2 (18 patients) according to the severity of the complications. When the groups were compared in terms of age, gender, BMI, presence of the previous operation, presence of sarcopenia, primary malignancy, peritoneal cancer index, and cytoreduction completeness scores, no statistical differences were found. When the serum albumin levels in the preoperative and postoperative seventy-second hour were compared, both groups had a significant decrease (p=0.011 and p=0.001, respectively). When the decrease rate of serum albumin levels was compared, there was no significant difference (p=0.539). There was a statistically significant difference between the preoperative and postoperative seventy-second-hour haemoglobin levels in both groups (p=0.01 and p=0.00, respectively). When the groups were compared according to the decrease rate in haemoglobin levels fall was more pronounced in patients with more severe complications (p=0.036). We concluded that the decrease in albumin levels and haemoglobin levels in the perioperative period is important and that a significant decrease in haemoglobin levels in the first seventy-two hours may be a pioneering data in terms of the development of serious complications. Therefore, closer monitoring of those patients and being more proactive in their treatment can contribute to the prevention of serious complications that may develop.

Keywords

Cytoreduction surgical procedures, Hyperthermic intraperitoneal chemotherapy, Prognosis, Albumin, Haemoglobin, Postoperative complications

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