Resumen de Hepatic resection and blood transfusion increase morbidity after cytoreductive surgery and HIPEC for colorectal carcinomatosis
Carla Soldevila Verdeguer, Juan José Segura Sampedro, Cristina Pineño Flores, Maria del Pilar Sanchís Cortés, Francesc Xavier González Argente, Rafael Morales Soriano
Background and objectivesCytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is an effective but complex treatment for peritoneal metastasis (PM). Our objective was to identify risk factors for postoperative morbidity and mortality following CRS-HIPEC.MethodsRetrospective study of prospectively collected data of patients undergoing CRS-HIPEC for PM arises from colo-rectal cancer between January 2008 and December 2017. Perioperative variables were correlated with morbidity outcomes using a logistic regression model.ResultsSixty-seven patients underwent CRS-HIPEC, and overall morbidity and mortality were 31.3% and 4.5% respec-tively. Major morbidity rate was 19.4%; 7.5% of patients were re-operated. Intraoperative blood transfusion (p = 0.01), liver resection (p < 0.01), and intestinal anastomosis (p < 0.01) were associated with a higher morbidity in univariate analysis. A multivariate analysis identified blood transfusion and liver resection as independent risk factors (OR 3.66, IC 1.13–16.54; OR 4.33, IC 1.17–11.46, respectively). Extension of visceral resection did not correlate with morbidity. Patients with lymph-node infiltration had a higher major complication rate (p = 0.01).ConclusionsCRS-HIPEC is a feasible treatment for colorectal PM with an acceptable morbi-mortality rate in experienced centers. In our study, digestive anastomosis, perioperative blood transfusion, hepatic resection, and lymph-node infiltration were associated with higher morbidity rates.
