Peritoneal Karsinomatoz için Komplet Sitoredüksiyon Yapılan Hastalarda Erken Morbidite ve Mortaliteyi Etkileyen Faktörler

Abstract

Amaç: Sitoredüktif cerrahi ve hipertermik intraperitoneal kemoterapi uygulaması, peritoneal karsinomatoz tedavisinde seçilmiş hastalarda kullanılan kombine tedavi yöntemidir. Materyal ve Methot: Çalışmamızda orijini farklı tümörlerin peritoneal metastazlarına bağlı olarak Sitoredüktif Cerrahi ve hipertermik intraperitoneal kemoterapi uygulanan hastalarda erken komplikasyonların gelişimini ve komplikasyonların erken evrelerini etkileyen faktörleri araştırdık. Hastanemizde 2014-2019 yılları arasında periton metastazı nedeniyle ameliyat edilen 76 hastanın tıbbi kayıtları retrospektif olarak değerlendirildi. Çalışmaya sadece tam sitoredüksiyon (CC/0) uygulanan 61 hasta dahil edildi. Bulgular: Periton Kanseri İndeksi (PKİ) ve operasyon süresinin majör komplikasyon gelişimi için bağımsız risk faktörleri olduğu bulundu. Majör komplikasyon gelişimi açısından ameliyat süresi 7 saat ve Periton Kanseri İndeksi kesme değeri sırasıyla 10 saat olarak bulundu. Sonuç: Çalışmamızda, CC/0 uygulanan hastalarda PKİ'nin ondan fazla olması ve ameliyat süresinin 7 saatten fazla sürmesinin majör komplikasyonları ve mortaliteyi artıran neden olduğunu gösterdik. CC / 0 rezeksiyonu yapmak için her türlü çaba gösterilmelidir, ancak PKG'si 10'un üzerinde olan hastalarda ve operasyon süresini 7 saatin üzerine uzatırken daha fazla özen gösterilmelidir. Bu hastalarda postoperatif komplikasyonlar perioperatif mortaliteyi artırarak erken rekürrens ve kısa sağkalıma neden olur.

Keywords

• komplet sitoredüksiyon
• hipertermik intraperitoneal kemoterapi
• peritoneal karsinomatoz

Factors Affecting Early Morbidity and Mortality in Patients with Complete Cytoreduction for Peritoneal Carcinomatosis

Abstract

Objective: Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy practice is the combined treatment modality used in selected patients for the treatment of peritoneal carcinomatosis. Material and Methods: In our study, we investigated the development of early complications and the factors affecting the early stages of complications in patients who underwent Cytoreductive Surgery and hyperthermic intraperitoneal chemotherapy due to peritoneal metastases of tumors of different origin. Medical records of 76 patients who operated in our hospital for peritoneal metastasis between 2014 and 2019 evaluated retrospectively. Only 61 patients who underwent complete cytoreduction (CC/0) included in the study. Results: Peritoneal Cancer Index and operation time found to be independent risk factors for major complication development. In terms of major complication development, operation time and Peritoneal Cancer Index cutoff value found to be 7 hours and 10 respectively. Conclusion: We have demonstrated in our study that the fact that the PCI is higher than ten and operation time lasts more than 7 hours is the reason that increases major complications and mortality in patients undergoing CC/0. All efforts should be made to perform CC/0 resection, but more care should be taken in patients having a PCI over 10 and when extending the operation time over 7 hours. In these patients, postoperative complications increase peri-operative mortality and lead to early recurrence and short survival.

Keywords

• complete cytoreduction
• hyperthermic intraperitoneal chemotherapy
• peritoneal carcinomatosis

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