Techniques for Avoiding Surgical Complications in Chemotherapy-Treated Cancer Patients

  • J. H. Raaf
Part of the Recent Results in Cancer Research book series (RECENTCANCER, volume 98)


With the development of more effective antineoplastic drugs for the treatment of solid malignant tumors, the use of systemic chemotherapy in the perioperative period has become increasingly attractive. Strategies have evolved for administering chemotherapy preoperatively to render large tumors more easily resected, intraoperatively in isolation-perfusion systems (often in combination with hyperthermia), and postoperatively as an adjuvant or to treat residual disease. It is possible, however, that the benefits of perioperative chemotherapy may be offset by an increase in the incidence of complications, particularly with respect to wound healing. The well-known toxic effects of chemother-apeutic agents on actively replicating normal cells suggest that antineoplastic drugs could easily lead to wound problems such as infection or dehiscence.


Wound Healing Vascular Access Nitrogen Mustard Solid Malignant Tumor PTFE Graft 
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  1. Ansfield FL, Korbitz BC, Davis HL, Raminez G (1969) Triple drug therapy in testicular tumors. Cancer 24:442–446PubMedCrossRefGoogle Scholar
  2. Argenta LC, Manders EK (1983) Mitomycin C extravasation injuries. Cancer 51:1080–1082PubMedCrossRefGoogle Scholar
  3. Calvo DB, Patt YZ, Wallace S, Chuang VP, Benjamin RS, Pritchard JD, Hersh EM, Bodey GP Sr, Mariglit GM (1980) Phase I–II trial of percutaneous intra-arterial cis-diamminedichloro platinum (II) for regionally confined malignancy. Cancer 45:1278–1283PubMedCrossRefGoogle Scholar
  4. Cohen SC, Gabelnick HL, Johnson RK, Goldin A (1975a) Effects of antineoplastic agents on wound healing in mice. Surgery 78:238–244Google Scholar
  5. Cohen SC, Gabelnick HL, Johnson RK, Goldin A (1975b) Effects of cyclophosphamide and Adriamycin on the healing of surgical wounds in mice. Cancer 36:1277–1281CrossRefGoogle Scholar
  6. Conn JH, Leb SM, Hardy JD (1957) Effect of nitrogen mustard and thio-TEPA on wound healing. Surg Forum 8:80–83PubMedGoogle Scholar
  7. Devereux DF, Thibault L, Boretos J, Brennan MF (1979) The quantitative and qualitative impairment of wound healing by Adriamycin. Cancer 43:932–938PubMedCrossRefGoogle Scholar
  8. Donegan WL (1974) Extended surgical adjuvant thio-TEPA for mammary carcinoma. Arch Surg 109:187–192PubMedCrossRefGoogle Scholar
  9. Farhat SM, Amer NS, Weeks DS, Musselman MM (1958) Effect of mechlorethamine hydrochloride (nitrogen mustard) on healing of abdominal wounds. Arch Surg 76:749–753CrossRefGoogle Scholar
  10. Ferguson MK (1982) The effect of antineoplastic agents on wound healing. Surg Gynecol Obstet 154:421–429PubMedGoogle Scholar
  11. Fernback DJ, Martyn DT (1966) Role of dactinomycin on the improved survival of children with Wilm’s tumor. JAMA 195:1005–1009CrossRefGoogle Scholar
  12. Goldman LI, Lowe S, Al-Saleem T (1969) Effect of fluorouracil on intestinal anastomoses in the rat. Arch Surg 98:303–304PubMedCrossRefGoogle Scholar
  13. Hardesty WH (1958) The effect of cytotoxic drugs on wound healing in rats. Cancer Res 18:581–584PubMedGoogle Scholar
  14. Hattori T, Ito I, Hirata K, Iizuka T, Abe K (1966) Results of combined treatment in patients with cancer of the stomach: palliative gastrectomy, large-dose mitomycin-C, and bone marrow transplantation. Gan 57:441–451PubMedGoogle Scholar
  15. Higgins GA, Dwight RW, Smith JV, Keehn RJ (1971) Fluorouracil as an adjuvant to surgery in carcinoma of the colon. Arch Surg 102:339–343PubMedCrossRefGoogle Scholar
  16. Jones TE, Newell ET, Brubaker RE (1941) The use of alloy steel wire in the closure of abdominal wounds. Surg Gynecol Obstet 72:1056–1059Google Scholar
  17. Karakousis CP (1979) Tourniquet infusion chemotherapy in extremities with malignant lesions. Surg Gynecol Obstet 149:481–490PubMedGoogle Scholar
  18. Karakousis CP (1980) One layer closure of the abdominal wall. Surg Gynecol Obstet 150:243–244PubMedGoogle Scholar
  19. Kardinal CG, Luce JK (1977) Evaluation of a hexamethylmelamine and 5-fluorouracil combination in the treatment of advanced ovarian carcinoma. Cancer Treat Rep 61:1691–1693PubMedGoogle Scholar
  20. Kelsen DP, Bains M, Hilaris B, Chapman R, McCormack P, Alexander T, Hopfan S, Martini N (1982) Combination chemotherapy of esophageal carcinoma using cisplatin, vindesine, and bleomycin. Cancer 49:1174–1177PubMedCrossRefGoogle Scholar
  21. Larson DL (1982) Treatment of tissue extravasation by antitumor agents. Cancer 49:1796–1782PubMedCrossRefGoogle Scholar
  22. Malt RA (1977) Abdominal incisions, sutures, and sacrilege. N Engl J Med 297:722–723PubMedCrossRefGoogle Scholar
  23. McBride CM, Smith JL, Brown BW (1981) Primary malignant melanoma of the limbs: a re-evaluation using microstaging techniques. Cancer 48:1463–1468PubMedCrossRefGoogle Scholar
  24. Morton DL, Eilber FR, Townsend CM, Grant TT, Mirra J, Weisenburger TH (1976) Limb salvage from a multidisciplinary treatment approach for skeletal and soft tissue sarcomas of the extremity. Ann Surg 184:268–278PubMedCrossRefGoogle Scholar
  25. Pisesky W, Williams HTG, MacKenzie WC (1959) The effect of triethylene thiophosphoramide (thio-TEPA) and 17-ethyl-19 nortestosterone (Nivelar) on wound healing. Can J Surg 2:291–294PubMedGoogle Scholar
  26. Raaf JH (1979) Vascular access grafts for chemotherapy: use in forty patients at M.D. Anderson Hospital. Ann Surg 190:614–622PubMedCrossRefGoogle Scholar
  27. Raaf JH (1980) Vascular access prostheses in the management of cancer patients. Clin Bull 10:91–101PubMedGoogle Scholar
  28. Raaf JH (1984a) Vascular access for chemotherapy. In: Waltzer WC (ed) Vascular Access Surgery chap 14. Grune and Stratton, New York, pp 161–192Google Scholar
  29. Raaf JH (1984b) Two Broviac catheters for intensive long-term support of cancer patients. Surg Gynecol Obstet 158:173–176Google Scholar
  30. Raaf JH, Ennis J (1982) Long-term percutaneous catheter inserted into a polytetrafluoroethylene graft for administration of chemotherapy. Arch Surg 117:514–515PubMedCrossRefGoogle Scholar
  31. Rath H, Enquist IF (1959) The effect of thio-TEPA on wound healing. Arch Surg 79:812–814PubMedCrossRefGoogle Scholar
  32. Rosen G, Caparros B, Huvos AG, Kosloff C, Nirenberg A, Cacavio A, Marcove R, Lane T, Mehta B, Urban C (1982) Preoperative chemotherapy for osteogenic sarcoma: selection of postoperative adjuvant chemotherapy based on the response of the primary tumor to preoperative chemotherapy. Cancer 49:1221–1230PubMedCrossRefGoogle Scholar
  33. Shamberger RC, Devereux DF, Brennan MF (1981) The effect of chemotherapeutic agents on wound healing. Int Adv Surg Oncol 4:15–58PubMedGoogle Scholar
  34. Shields, TW, Humphrey EW, Eastridge CE, Keehn RJ (1977) Adjuvant cancer chemotherapy after resection of carcinoma of the lung. Cancer 40:2057–2062PubMedCrossRefGoogle Scholar
  35. Staley CJ, Trippel OH, Preston FW (1961) Influence of 5-fluorouracil on wound healing. Surgery 49:450–453Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1985

Authors and Affiliations

  • J. H. Raaf
    • 1
  1. 1.Cleveland Clinic Cancer CenterClevelandUSA

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