Diagnostic Laparoscopy in Patients With Peritoneal Carcinomatosis Is Safe and Does Not Delay Cytoreductive Surgery With Hyperthermic Intraperitoneal Chemotherapy.
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Chemotherapy, Cancer, Regional Perfusion
/ methods
Colorectal Neoplasms
/ pathology
Combined Modality Therapy
Cytoreduction Surgical Procedures
Humans
Hyperthermia, Induced
/ methods
Hyperthermic Intraperitoneal Chemotherapy
Laparoscopy
/ methods
Peritoneal Neoplasms
/ diagnosis
Retrospective Studies
cytoreductive surgery with hyperthermic intraperitoneal chemotherapy
diagnostic laparoscopy
hyperthermic intraperitoneal chemotherapy
peritoneal carcinomatosis
surgical oncology
Journal
The American surgeon
ISSN: 1555-9823
Titre abrégé: Am Surg
Pays: United States
ID NLM: 0370522
Informations de publication
Date de publication:
Apr 2022
Apr 2022
Historique:
pubmed:
5
11
2021
medline:
17
3
2022
entrez:
4
11
2021
Statut:
ppublish
Résumé
Outcomes of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) among patients with peritoneal carcinomatosis (PC) depend largely on the extent of peritoneal disease. Since PC is not reliably evaluated with cross-sectional imaging, tumor burden is often evaluated with diagnostic laparoscopy (DLS). The aims of this study are to evaluate the safety of DLS in patients with peritoneal disease and determine if DLS delays time to CRS-HIPEC. We performed an institutional retrospective review of 145 patients who underwent CRS-HIPEC between 2013 and 2020. Patients were divided into 2 groups: those who underwent an electively scheduled DLS prior to CRS-HIPEC and those who did not. Intraoperative and postoperative complications associated with DLS were determined from the surgeon's operative report. Time from diagnosis of PC to CRS-HIPEC was compared between the 2 groups. Of the 145 patients available for analysis, 47% (68) underwent DLS and 44% (64) did not. Of all the diagnostic laparoscopies performed, there was 1 (1.5%) intraoperative complication. The duration between diagnosis of peritoneal carcinomatosis and surgery was 4.9 months among patients who underwent DLS prior to CRS-HIPEC and 4.3 months among patients who did not ( In this retrospective analysis, diagnostic laparoscopy prior to CRS-HIPEC demonstrated a comparable rate of DLS-associated complications compared to other gastrointestinal malignancies and does not prolong time from diagnosis to CRS-HIPEC. Thus, in patients undergoing evaluation for CRS-HIPEC, diagnostic laparoscopy provides significant value in patient selection without incurring perioperative risk or delay in CRS-HIPEC.
Sections du résumé
BACKGROUND
BACKGROUND
Outcomes of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) among patients with peritoneal carcinomatosis (PC) depend largely on the extent of peritoneal disease. Since PC is not reliably evaluated with cross-sectional imaging, tumor burden is often evaluated with diagnostic laparoscopy (DLS). The aims of this study are to evaluate the safety of DLS in patients with peritoneal disease and determine if DLS delays time to CRS-HIPEC.
METHODS
METHODS
We performed an institutional retrospective review of 145 patients who underwent CRS-HIPEC between 2013 and 2020. Patients were divided into 2 groups: those who underwent an electively scheduled DLS prior to CRS-HIPEC and those who did not. Intraoperative and postoperative complications associated with DLS were determined from the surgeon's operative report. Time from diagnosis of PC to CRS-HIPEC was compared between the 2 groups.
RESULTS
RESULTS
Of the 145 patients available for analysis, 47% (68) underwent DLS and 44% (64) did not. Of all the diagnostic laparoscopies performed, there was 1 (1.5%) intraoperative complication. The duration between diagnosis of peritoneal carcinomatosis and surgery was 4.9 months among patients who underwent DLS prior to CRS-HIPEC and 4.3 months among patients who did not (
CONCLUSION
CONCLUSIONS
In this retrospective analysis, diagnostic laparoscopy prior to CRS-HIPEC demonstrated a comparable rate of DLS-associated complications compared to other gastrointestinal malignancies and does not prolong time from diagnosis to CRS-HIPEC. Thus, in patients undergoing evaluation for CRS-HIPEC, diagnostic laparoscopy provides significant value in patient selection without incurring perioperative risk or delay in CRS-HIPEC.
Identifiants
pubmed: 34732056
doi: 10.1177/00031348211048819
pmc: PMC9069552
mid: NIHMS1794939
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
698-703Subventions
Organisme : NCI NIH HHS
ID : T32 CA106183
Pays : United States
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