Su1739 Risk Factors for Pulmonary Embolism Following Cytoreductive Surgery and Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis

医学 温热腹腔化疗 外科 腹膜假性粘液瘤 肺栓塞 前瞻性队列研究 癌症 细胞减少术 卵巢癌 内科学 附录 生物 古生物学
作者
Judy Chiou,Vladana Vukadinovic,David L. Morris
出处
期刊:Gastroenterology [Elsevier BV]
卷期号:148 (4): S-1135
标识
DOI:10.1016/s0016-5085(15)33869-5
摘要

Introduction: Peritoneal carcinomatosis denotes extensive tumour involvement of the peritoneum, and is often regarded as terminal. There has been a paradigm shift in treatment, with the application of cytoreductive surgery combined with intra-peritoneal chemotherapy. The extensive nature of the surgery and malignancy-associated hypercoagulable state should increase the risk of PE, which can further increase morbidity and/or mortality. Incidence and risk factors for pulmonary embolism (PE) in this population have not been investigated in detail. Aims: To establish the incidence and specific operative risk factors for developing PE in patients with peritoneal carcinomatosis post peritonectomy and peri-operative intraperitoneal chemotherapy. Methods: A cohort of 596 patients that underwent cytoreductive surgery (peritonectomy) over a 12-year period was identified using the prospective database from St George Hospital Peritonectomy Unit. A case-control study was undertaken whereby cases were defined by the development of PE within 60 days of peritonectomy. A diagnosis of PE was based on computed tomography pulmonary angiography confirmation. The prospective database was reviewed to obtain the following clinical information for both cases (with PE) and controls (without PE): length of surgery, use of hyperthermic intraperitoneal chemotherapy (HIPEC) and early postoperative intraperitoneal chemotherapy (EPIC), peritoneal carcinomatosis index (PCI) and number of intraoperative blood transfusions. Results: The mean age of the cohort was 52.7 ± 13.1 years, with no significant difference in the ages of cases or controls; 43.3% were male and 56.7% were female. Primary malignancies in these patients were pseudomyxoma peritonei, appendiceal, ovarian or colorectal cancer, and mesothelioma. Out of the 596 patient cohort, 34 were identified as having PE post cytoreductive surgery (5.7%). When compared to controls, the PE group had longer mean operative time of 10.4 ± 2.8 hours vs 8.9 ± 3.1 hours (p=0.01) and higher mean PCI values at 23 ± 12 vs 18 ± 11 (p=0.02). An operative time of more >9 hours increased the risk of developing PE (OR 3.3, 95% CI 1.41-7.72, p=0.006) as did having a PCI of >20 (OR 2.4, 95% CI 1.18-4.9, p=0.02). There was no difference in mean transfusion requirements (6.6 vs 6.0; p=0.67). No significant association was found between HIPEC and development of PE (x2=2.87, 1 df, P=0.9) or EPIC and subsequent PE (x2=0.001, 1 df, P=1). Conclusions: There is a relatively high incidence of pulmonary embolism in patients following cytoreductive surgery for peritoneal carcinomatosis. Patients at highest risk of developing PE postoperatively are those with PCI of more than 20 and those who have operations lasting more than 9 hours. Peri-operative chemotherapy and blood transfusions are not risk factors for PE.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
胡胡完成签到 ,获得积分10
刚刚
火星上小土豆完成签到 ,获得积分10
10秒前
杰尼龟的鱼完成签到 ,获得积分10
14秒前
安然完成签到 ,获得积分10
15秒前
张希伦完成签到 ,获得积分10
15秒前
任性翠安完成签到 ,获得积分10
19秒前
dong完成签到 ,获得积分10
21秒前
神说完成签到,获得积分0
23秒前
量子星尘发布了新的文献求助10
29秒前
Aimee完成签到 ,获得积分10
29秒前
徐彬荣完成签到,获得积分10
30秒前
研友_8yN60L完成签到,获得积分10
31秒前
搜集达人应助科研通管家采纳,获得10
31秒前
光亮的自行车完成签到 ,获得积分10
31秒前
李东东完成签到 ,获得积分10
46秒前
王多肉完成签到,获得积分10
50秒前
Iiiilr完成签到 ,获得积分10
51秒前
杨幂完成签到,获得积分10
52秒前
59秒前
hellokitty完成签到,获得积分10
1分钟前
1分钟前
小四发布了新的文献求助10
1分钟前
1分钟前
西瓜完成签到 ,获得积分10
1分钟前
包容的忆灵完成签到 ,获得积分10
1分钟前
高兴尔冬发布了新的文献求助10
1分钟前
xiang完成签到 ,获得积分0
1分钟前
小四完成签到,获得积分10
1分钟前
FashionBoy应助slayers采纳,获得30
1分钟前
量子星尘发布了新的文献求助10
1分钟前
黑眼圈完成签到 ,获得积分10
1分钟前
jia完成签到 ,获得积分10
1分钟前
如履平川完成签到 ,获得积分10
1分钟前
科目三应助忧伤的步美采纳,获得10
1分钟前
大椒完成签到 ,获得积分10
1分钟前
1分钟前
1分钟前
wisdom完成签到,获得积分10
1分钟前
slayers发布了新的文献求助30
1分钟前
1分钟前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Handbook of Industrial Diamonds.Vol2 1100
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038039
求助须知:如何正确求助?哪些是违规求助? 3575756
关于积分的说明 11373782
捐赠科研通 3305574
什么是DOI,文献DOI怎么找? 1819239
邀请新用户注册赠送积分活动 892655
科研通“疑难数据库(出版商)”最低求助积分说明 815022