Safety of rectum anastomosis after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

von Breitenbuch, Philipp and Piso, Pompiliu and Schlitt, Hans J. (2018) Safety of rectum anastomosis after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. JOURNAL OF SURGICAL ONCOLOGY, 118 (3). pp. 551-556. ISSN 0022-4790, 1096-9098

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Abstract

Background and ObjectivesIn highly selected patients with peritoneal carcinomatosis, cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) can be an aggressive but worthwhile treatment regimen. Resection of the rectosigmoid is frequently performed with CRS. The aim of the study was to assess the safety of the rectal anastomosis in this setting. MethodsBetween 2005 and 2016, 436 patients underwent CRS/HIPEC. Clinical data were analyzed with respect to the morbidity associated with a rectum resection. ResultsIn 436 patients, 174 rectum resections (40%) were performed with CRS, including 149 anterior resections of the rectosigmoid, 23 low anterior rectum resections, and 2 abdominoperineal rectum excisions. A total of 141 rectum anastomoses were performed; 33 patients received a permanent ostomy, and 48 patients received a protective ileostomy. After changing the operation technique of the rectum anastomosis, the number of protective ileostomies decreased from 65% to 20%. The overall postoperative morbidity was 31%. Rectal anastomotic leakages were seen in only 5% of cases. ConclusionsAnastomotic leakages of the rectum are rarely seen after CRS/HIPEC. HIPEC performed immediately after surgery seems to have no negative effect on the rectum anastomosis. Performing rectum anastomoses after CRS/ HIPEC appears to be a safe procedure.

Item Type: Article
Uncontrolled Keywords: PERITONEAL CARCINOMATOSIS; COLOANAL ANASTOMOSIS; RISK-FACTORS; CANCER; RESECTION; MORBIDITY; MORTALITY; EXCISION; LEAKAGE; cytoreduction; peritoneal carcinomatosis (PC); rectum resection
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Chirurgie
Depositing User: Dr. Gernot Deinzer
Date Deposited: 09 Jan 2020 07:23
Last Modified: 09 Jan 2020 07:23
URI: https://pred.uni-regensburg.de/id/eprint/13946

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