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Re-operations for early postoperative complications after CRS and HIPEC: indication, timing, procedure, and outcome

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Abstract

Purpose

Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have become standard of care for many peritoneal malignancies in selected patients. Nevertheless, this aggressive treatment strategy is associated with significant major morbidity. The aim of the present study is to analyze the re-operation rate and clinical outcome following CRS and HIPEC.

Patients and methods

In the present study, prospectively documented data of 474 consecutive patients treated with CRS and HIPEC between February 2011 and December 2015 in a high-volume certified reference center for peritoneal malignancies in Germany have been retrospectively analyzed.

Results

The re-operation rate was 14.5%. The most frequent reasons for revisional surgery were fascial dehiscence, intraabdominal hemorrhage, and anastomotic leak. Most complications occurred between postoperative day 7 and 9. However, postoperative bleeding was more common within the first 5 days after surgery. The overall in-hospital mortality rate was 2.1% for all patients and 10% after revisional surgery.

Conclusions

CRS and HIPEC are associated with an acceptable re-operation rate and low mortality rate. Most frequently, re-operations are performed on 7–9 days after initial surgery due to fascial dehiscence, pancreatitis, or anastomotic leak. Postoperative bleedings are more common within the first 5 days after surgery.

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Authors and Affiliations

  1. Department of General and Visceral Surgery, Krankenhaus Barmherzige Brüder, Prüfeninger Strasse 86, 93049, Regensburg, Germany

    Sebastian Blaj, Sebastian Nedelcut, Max Mayr, Hubert Leebmann & Pompiliu Piso

  2. Department of Informatics, University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania

    Daniel Leucuta

  3. Department of Surgery, München Klinik Bogenhausen, Munich, Germany

    Gabriel Glockzin

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  1. Sebastian Blaj
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  2. Sebastian Nedelcut
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  7. Pompiliu Piso
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Correspondence to Pompiliu Piso.

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This study includes anonymized prospectively gathered patients data. Informed consent was obtained from all participants included in this study.

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Blaj, S., Nedelcut, S., Mayr, M. et al. Re-operations for early postoperative complications after CRS and HIPEC: indication, timing, procedure, and outcome. Langenbecks Arch Surg 404, 541–546 (2019). https://doi.org/10.1007/s00423-019-01808-8

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  • DOI: https://doi.org/10.1007/s00423-019-01808-8

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