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Rare diaphragmatic complications following cytoreductive surgery and HIPEC: report of two cases

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Abstract

Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have been proven to be an effective treatment modality for selected patients with peritoneal surface malignancies. The most common surgical complications after CRS and HIPEC are anastomotic leakage, intestinal obstruction and peripancreatitis. This case report presents two patients with early and late postoperative diaphragmatic hernia after CRS and HIPEC. One patient that initially had pseudomyxoma peritonei complained of persistent chest pain and dyspeptic disorder after peritonectomy and HIPEC and underwent reoperation due to a left diaphragmatic hernia containing the splenocolic flexure. The other patient had gastric cancer and peritoneal carcinomatosis and developed anastomotic leakage of the transverse colon anastomosis and pleural empyema. Stripping of the diaphragm is often performed during CRS, sometimes combined with diaphragmatic resection. A herniation through a diaphragmatic defect is rarely diagnosed during either the early or late postoperative period. Direct suture of the defect or closure with synthetic or biological tissue are possible surgical techniques for repair with a good prognosis.

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None of the authors have any conflict of interest.

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Authors and Affiliations

  1. Department of General Surgery, St. John of God Hospital, Regensburg, Germany

    Benedikt Lampl, Hubert Leebmann, Max Mayr & Pompiliu Piso

  2. Klinik fur Allgemein- und Viszeralchirurgie, Krankenhaus Barmherzige Bruder Regensburg, Prufeninger Strase 86, 93049, Regensburg, Germany

    Benedikt Lampl

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  1. Benedikt Lampl
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  2. Hubert Leebmann
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  3. Max Mayr
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  4. Pompiliu Piso
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Correspondence to Benedikt Lampl.

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Lampl, B., Leebmann, H., Mayr, M. et al. Rare diaphragmatic complications following cytoreductive surgery and HIPEC: report of two cases. Surg Today 44, 383–386 (2014). https://doi.org/10.1007/s00595-012-0445-9

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  • DOI: https://doi.org/10.1007/s00595-012-0445-9

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