Patients undergoing cytoreductive surgery for peritoneal malignancy of appendiceal origin should be consented for umbilical excision as 30% have umbilical infiltration

2021 ◽  
Author(s):  
Shinichiro Sakata ◽  
Tun G. Tan ◽  
Danko Kostadinov ◽  
Nima Ahmadi ◽  
Sanjeev P. Dayal ◽  
...  
Keyword(s):  
Cytoreductive Surgery ◽  
Peritoneal Malignancy

scholarly journals Postoperative paralytic ileus after cytoreductive surgery combined with heated intraperitoneal chemotherapy

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Jesper Nors ◽  
Jonas Amstrup Funder ◽  
David Richard Swain ◽  
Victor Jilbert Verwaal ◽  
Tom Cecil ◽  
...  
Keyword(s):  
Median Time ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Paralytic Ileus ◽  
University Hospital ◽  
Nasojejunal Tube ◽  
Heated Intraperitoneal Chemotherapy ◽  
Duration Of Surgery ◽  
Crs And Hipec ◽  
Peritoneal Malignancy

AbstractBackgroundPatients with peritoneal malignancy treated by cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) are prone to develop postoperative paralytic ileus (POI). POI is associated with significant increase in both morbidity and mortality. CRS and HIPEC commonly result in prolonged POI (PPOI). The objective was to clarify the extent of PPOI in patients treated by CRS and HIPEC for peritoneal malignancy.MethodsThis was a prospective multicenter study including patients operated with CRS and HIPEC at the Department of Surgery, Aarhus University Hospital, Denmark and the Peritoneal Malignancy Institute, Basingstoke, United Kingdom. A total of 85 patients were included over 5 months. Patients prospectively reported parameters of postoperative gastrointestinal function in a diary from post-operative day 1 (POD1) until discharge. PPOI was defined as first defecation on POD6 or later.ResultsMedian time to first flatus passage was 4 days (range 1–12). Median time to first defecation was 6 days (1–14). Median time to removal of nasojejunal tube was 4 days (3–13) and 7 days (1–43) for nasogastric tube. Forty-six patients (54%) developed PPOI. Patients with PPOI had longer time to first flatus (p<0.0001) and longer time to removal of nasojejunal tube (p=0.001). Duration of surgery correlated to time to first flatus (p=0.015) and time to removal of nasogastric or nasojejunal tube (p<0.0001) but not to time to first defecation (p=0.321).ConclusionsPostoperative gastrointestinal paralysis remains a common and serious problem in patients treated with CRS and HIPEC.

scholarly journals An update of peritonectomy procedures used in cytoreductive surgery for peritoneal malignancy

2019 ◽  
Vol 36 (1) ◽  
pp. 743-751
Author(s):  
Frédéric Mercier ◽  
Faheez Mohamed ◽  
Jean-Baptiste Cazauran ◽  
Vahan Kepenekian ◽  
Delphine Vaudoyer ◽  
...  
Keyword(s):  
Cytoreductive Surgery ◽  
Peritonectomy Procedures ◽  
Peritoneal Malignancy

scholarly journals Do patients undergoing cytoreductive surgery and HIPEC for peritoneal malignancy need parenteral nutrition?

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
David R. Swain ◽  
Allison L. Yates ◽  
Faheez Mohamed ◽  
Sanjeev P. Dayal ◽  
Alexios Tzivanakis ◽  
...  
Keyword(s):  
Parenteral Nutrition ◽  
Cytoreductive Surgery ◽  
Nutritional Assessment ◽  
Primary Tumour ◽  
Arm Circumference ◽  
Significant Difference ◽  
Two Factors ◽  
Crs And Hipec ◽  
Mid Upper Arm Circumference ◽  
Peritoneal Malignancy

AbstractBackgroundTo analyse the duration of parenteral nutrition (PN) in patients treated for peritoneal malignancy with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) over a 2 year period at a single UK National referral centre.MethodsA retrospective analysis of prospective data for all patients (n=321) who underwent CRS and HIPEC for peritoneal malignancy at the Peritoneal Malignancy Institute Basingstoke between April 1, 2013 and March 31, 2015.Duration of PN was compared between primary tumour site (appendix, colorectal, mesothelioma and other); completeness of CRS (complete CRS vs. major tumour debulking) and pre-operative nutritional assessment measures (including Mid Upper Arm Circumference).ResultsThe median duration of PN was 9 days (range 2–87 days). A total of 13 % of patients had PN for less than 7 days and 6 % for 5 days or less. There was no significant difference in duration of PN between the different tumour sites. Two factors that may increase the duration of PN include having major tumour debulking (MTD) and a baseline MUAC<23.5 cm.ConclusionsMost patients who underwent CRS and HIPEC for peritoneal malignancy required PN for more than 7 days with poor pre-operative nutritional status and inability to achieve complete cytoreduction predictors of prolonged PN requirements.

scholarly journals Physical, psychological and nutritional outcomes in a cohort of Irish patients with metastatic peritoneal malignancy scheduled for cytoreductive surgery (CRS) and heated intrapertioneal chemotherapy (HIPEC): An exploratory pilot study

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0242816
Author(s):  
Lisa Loughney ◽  
Noel McCaffrey ◽  
Claire M. Timon ◽  
Joshua Grundy ◽  
Andrew McCarren ◽  
...  
Keyword(s):  
Pilot Study ◽  
Outcome Measures ◽  
Cytoreductive Surgery ◽  
Secondary Outcome ◽  
Lower Body ◽  
Body Strength ◽  
Lower Body Strength ◽  
Peritoneal Malignancy ◽  
Nutritional Outcomes

Background Treatment for peritoneal malignancy (PM) can include cytoreductive surgery (CRS) and heated intrapertioneal chemotherapy (HIPEC) and is associated with morbidity and mortality. Physical, psychological and nutritional outcomes are important pre-operatively. The aim of this pilot study was to investigate these outcomes in patients with PM before and after CRS-HIPEC. Methods Between June 2018 and November 2019, participants were recruited to a single-centre study. Primary outcome was cardiopulmonary exercise testing (CPET) variables oxygen uptake (VO2) at anaerobic threshold (AT) and at peak. Secondary outcome measures were upper and lower body strength, health related quality of life (HRQoL) and the surgical fear questionnaire. Exploratory outcomes included body mass index, nutrient intake and post-operative outcome. All participants were asked to undertake assessments pre CRS-HIPEC and 12 weeks following the procedure. Results Thirty-nine patients were screened, 38 were eligible and 16 were recruited. Ten female and 6 male, median (IQR) age 53 (42–63) years. Of the 16 patients recruited, 14 proceeded with CRS-HIPEC and 10 competed the follow up assessment at week 12. Pre-operative VO2 at AT and peak was 16.8 (13.7–18) ml.kg-1.min-1 and 22.2 (19.3–25.3) ml.kg-1.min-1, upper body strength was 25.9 (20.3–41.5) kg, lower body strength was 14 (10.4–20.3) sec, HRQoL (overall health status) was 72.5 (46.3–80) % whilst overall surgical fear was 39 (30.5–51). The VO2 at AT decreased significantly (p = 0.05) and HRQoL improved (p = 0.04) between pre and post- CRS-HIPEC. There were no significant differences for any of the other outcome measures. Conclusion This pilot study showed a significant decrease in VO2 at AT and an improvement in overall HRQoL at the 12 week follow up. The findings will inform a larger study design to investigate a prehabilitation and rehabilitation cancer survivorship programme.

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