Annals of Surgical Oncology

, Volume 12, Issue 11, pp 910–918

Bowel Complications in 203 Cases of Peritoneal Surface Malignancies Treated With Peritonectomy and Closed-Technique Intraperitoneal Hyperthermic Perfusion

  • Rami Younan
  • Shigeki Kusamura
  • Dario Baratti
  • Grazia Daniela Oliva
  • Pasqualina Costanzo
  • Myriam Favaro
  • Cecilia Gavazzi
  • Marcello Deraco
Original Articles

Abstract

Background

Peritonectomy and intraperitoneal hyperthermic perfusion (IPHP) are increasingly used in the management of carcinomatosis of various sites of origin. We analyzed the risk factors for bowel complications with primary anastomoses and the closed technique for IPHP.

Methods

From 1995 to 2004, 203 consecutive procedures were performed at the National Cancer Institute of Milan. We retrospectively analyzed this series of patients. Treated pathologies included peritoneal mesothelioma; pseudomyxoma peritonei; colorectal, ovarian, or gastric carcinomatosis; and abdominal sarcomatosis. All digestive anastomoses were performed before the IPHP. Only one defunctioning stoma was used.

Results

We found a bowel complication rate of 10.8%. The bowel complications:anastomoses ratio was 11.3%. On univariate analysis we found a statistically significant association between bowel complications and the following variables: sex, previous systemic chemotherapy status, number of anastomoses ( fewer than two vs. two or more), duration of the procedure (<8.7 vs. ≥8.7 hours), and extent of cytoreduction. After multivariate analysis, male sex (odds ratio [OR], 4.2), no previous systemic chemotherapy (OR, 3.5), and duration of the procedure ≥8.7 hours (OR, 6.3) were considered independent risk factors for bowel complications.

Conclusions

Bowel complications are not increased when primary unprotected anastomoses are performed during peritonectomy and IPHP when the closed technique is used. Male sex, duration of the procedure, and no previous systemic chemotherapy are independent unfavorable risk factors.

Keywords

Peritoneal carcinomatosis Peritonectomy Intraperitoneal hyperthermic perfusion Intestinal complications. 

Copyright information

© The Society of Surgical Oncology, Inc. 2005

Authors and Affiliations

  • Rami Younan
    • 1
    • 2
  • Shigeki Kusamura
    • 1
    • 3
  • Dario Baratti
    • 1
  • Grazia Daniela Oliva
    • 1
    • 4
  • Pasqualina Costanzo
    • 5
  • Myriam Favaro
    • 6
  • Cecilia Gavazzi
    • 7
  • Marcello Deraco
    • 1
  1. 1.Department of Surgery, Melanoma and Sarcoma UnitNational Cancer Institute of MilanItaly
  2. 2.Department of Surgery, Surgical Oncology UnitCentre Hospitalier de l’Université de Montreal, University of Montreal Health CenterCanada
  3. 3.Department of Obstetrics and GynecologySchool of Medical Science, Universidade Estadual de CampinasBrazil
  4. 4.Unit of Emergency Surgery and Organ TransplantUniversità degli Studi di Messina, Policlinico G. MartinoItaly
  5. 5.Department of AnesthesiologyNational Cancer Institute of MilanItaly
  6. 6.Department of Critical CareNational Cancer Institute of MilanItaly
  7. 7.Nutritional Care UnitNational Cancer Institute of MilanItaly

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