Rare diaphragmatic complications following cytoreductive surgery and HIPEC: report of two cases
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
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.
- Sugarbaker PH. Peritonectomy procedures. Ann Surg. 1995;221(1):29–42. CrossRef
- Piso P, Glockzin G, von Breitenbuch P, Sulaiman T, Popp F, Dahlke M, Esquivel J, Schlitt HJ. Patient selection for a curative approach to carcinomatosis. Cancer J. 2009;15(3):236–42. (review). CrossRef
- Glockzin G, Schlitt HJ, Piso P. Peritoneal carcinomatosis: patients selection, perioperative complications and quality of life related to cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. World J Surg Oncol. 2009;7:5. (review). CrossRef
- Kitai T, Kawashima M, Yamanaka K, Ichijima K, Fujii H, Mashima S, Shimahara Y. Cytoreductive surgery with intraperitoneal chemotherapy to treat pseudomyxoma peritonei at nonspecialized hospitals. Surg Today. 2011;41(9):1219–23. CrossRef
- Chua TC, Yan TD, Saxena A. Morris DL Should the treatment of peritoneal carcinomatosis by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy still be regarded as a highly morbid procedure?: a systematic review of morbidity and mortality. Ann Surg. 2009;249(6):900–7. (review). CrossRef
- Piso P, Arnold D. Multimodal treatment approaches for peritoneal carcinosis in colorectal cancer. Dtsch Arztebl Int. 2011;108(47):802–8.
- Casado-Adam A, Alderman R, Stuart O A, Chang D, Sugarbaker P H. Gastrointestinal complications in 147 consecutive patients with peritoneal surface malignancy treated by cytoreductive surgery and perioperative intraperitoneal chemotherapy. Clinical study. Int J Surg Oncol. 2011;2011:468698. doi:10.1155/2011/468698.
- Glehen O, Osinsky D, Cotte E, Kwiatkowski F, Freyer G, Isaac S, Trillet-Lenoir V, Sayag-Beaujard AC, Francois Y, Vignal J, Gilly FN. Intraperitoneal chemohyperthermia using a closed abdominal procedure and cytoreductive surgery for the treatment of peritoneal carcinomatosis: morbidity and mortality analysis of 216 consecutive procedures. Ann Surg Oncol. 2003;10(8):863–9. CrossRef
- Kusamura S, Younan R, Baratti D, Costanzo P, Favaro M, Gavazzi C, Deraco M. Cytoreductive surgery followed by intraperitoneal hyperthermic perfusion. Analysis of morbidity and mortality in 209 peritoneal surface malignancies treated with closed abdomen technique. Cancer. 2006;106(5):1144–53. CrossRef
- Hansson J, Graf W, Pahlman L, Nygren P, Mahteme H. Postoperative adverse events and long-term survival after cytoreductive surgery and intraperitoneal chemotherapy. Eur J Surg Oncol. 2009;35(2):202–8. CrossRef
- Youssef H, Newman C, Chandrakumaran K, Mohamed F, Cecil TD, Moran BJ. Operative findings, early complications, and long-term survival in 456 patients with pseudomyxoma peritonei syndrome of appendiceal origin. Dis Colon Rectum. 2011;54(3):293–9. CrossRef
- Younan R, Kusamura S, Baratti D, Oliva GD, Costanzo P, Favaro M, Gavazzi C, Deraco M. Bowel complications in 203 cases of peritoneal surface malignancies treated with peritonectomy and closed-technique intraperitoneal hyperthermic perfusion. Ann Surg Oncol. 2005;12(11):910–8. CrossRef
- Smeenk RM, Verwaal VJ, Zoetmulder FA. Learning curve of combined modality treatment in peritoneal surface disease. Br J Surg. 2007;94(11):1408–14. CrossRef
- Laterza B, Baratti D, Cozzi G, Kusamura S, Oliva GD, Gavazzi C, Fumagalli L, Sironi A, Sabia D, Deraco M. Colobronchial fistula: an unusual complication after peritonectomy and hyperthermic intraperitoneal chemotherapy (HIPEC). In Vivo. 2009;23(1):151–3.
- Eren S, Ciriş F. Diaphragmatic hernia: diagnostic approaches with review of the literature. Eur J Radiol. 2005;54(3):448–59. (review). CrossRef
- Rare diaphragmatic complications following cytoreductive surgery and HIPEC: report of two cases
Volume 44, Issue 2 , pp 383-386
- Cover Date
- Print ISSN
- Online ISSN
- Springer Japan
- Additional Links
- Diaphragmatic complications
- Industry Sectors
- Author Affiliations
- 1. Department of General Surgery, St. John of God Hospital, Regensburg, Germany
- 2. Klinik fur Allgemein- und Viszeralchirurgie, Krankenhaus Barmherzige Bruder Regensburg, Prufeninger Strase 86, 93049, Regensburg, Germany