Postoperative infections after cytoreductive surgery and HIPEC for peritoneal carcinomatosis: Proposal and results from a prospective protocol study of prevention, surveillance and treatment

被引：29

作者：

Valle, M. ^{[1
]}

Federici, O. ^{[1
]}

Carboni, F. ^{[1
]}

Toma, L. ^{[2
]}

Gallo, M. T. ^{[3
]}

Prignano, G. ^{[3
]}

Giannarelli, D. ^{[4
]}

Cenci, L. ^{[1
]}

Garofalo, A. ^{[1
]}

机构：

[1] Regina Elena Inst Canc Res, Dept Digest Surg, I-00144 Rome, Italy

[2] Regina Elena Inst Canc Res, Dept Infectivol, I-00144 Rome, Italy

[3] Regina Elena Inst Canc Res, Dept Clin Pathol & Microbiol, I-00144 Rome, Italy

[4] Regina Elena Inst Canc Res, Dept Biostat, Rome, Italy

来源：

EJSO | 2014年 / 40卷 / 08期

关键词：

Peritonectomy; Infection; HIPEC; PERIOPERATIVE INTRAPERITONEAL CHEMOTHERAPY; SURGICAL SITE INFECTION; MORBIDITY; MORTALITY; GUIDELINE; DIAGNOSIS; RISK;

D O I：

10.1016/j.ejso.2013.10.015

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 [肿瘤学];

摘要：

The incidence of infectious complications due to several contributory causes is particularly elevated and life-threatening in patients undergoing peritonectomy and HIPEC procedure for peritoneal carcinomatosis. Following a previous experience, we started a prospective protocol study of preoperative screening, perioperative prophylaxis and postoperative surveillance and treatment. A total of 111 patients with peritoneal carcinomatosis of various origin underwent CRS with HIPEC between April 2004 and December 2012. The group was divided into a pilot group of 30 patients (04/04 to 05/08) and a main group of 81 patients (06/08 to 12/12). Overall postoperative morbidity rate was 44%, with 35.8% of symptomatic infections. No post-operative mortality was observed. Microorganisms were isolated in 24 patients (80.0%) in the first group and 54 (66.7%) in the second. They were symptomatic in 18 cases (75.0%) and 25 (46.3%) cases respectively. In addition, 7 invasive candidosis were recorded (25.9%). Colon resection (P = 0.01) and duration of surgery (P = 0.0008) were associated with infection at logistic regression model. Concerning symptomatic infections, only Infection Risk Index (P = 0.009) showed significance at multivariate analysis. Despite a significant incidence of infectious complications, establishment of a prevention, surveillance and treatment protocol lead to a zero mortality rate in the observed patients of our experience. Owing to the obtained results, we suggest the use of a standardized protocol for the prevention, monitoring and treatment in all patients enrolled for cytoreductive surgery and HTPEC. (C) 2013 Elsevier Ltd. All rights reserved.

引用

页码：950 / 956

页数：7

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