Temporary abdominal closure in oncological patients: Surgical characteristics and implications

医学 腹膜炎 腹腔隔室综合征 外科 体质指数 死亡率 共病 负压伤口治疗 癌症 腹部外科 腹部 内科学 病理 替代医学
作者
Daniel José Szor,Rodrigo Ambar Pinto,Carlos de Almeida Obregon,Francisco Tustumi,Fernando Perazzo,Lucas Catapreta Stolzemburg,Sérgio Silveira Júnior,Ulysses Ribeiro
出处
期刊:Journal of Surgical Oncology [Wiley]
标识
DOI:10.1002/jso.27729
摘要

Abstract Background and Objectives In critically ill patients, temporary abdominal closure (TAC) is utilized for conditions like abdominal compartment syndrome risk, gross abdominal contamination, and intestinal loop viability doubts. TAC techniques aim to safeguard abdominal contents, drain intraperitoneal fluids, and minimize fascia and skin damage. Our goal is to outline clinical characteristics and surgical outcomes in oncological patients undergoing peritoneostomy. Methods Patients undergoing TAC with vacuum therapy at a tertiary oncological center were studied, with data sourced from an institutional database. Results Forty‐seven patients (54.3% female), with an average age of 63.1 ± 12.3 years, were included in the study. The primary tumor site was predominantly gastrointestinal (78.2%). Patients presented systemic signs of chronic disease, reflected by a mean body mass index of 18.2 ± 7.6 kg/m², hemoglobin level of 9.2 ± 1.8 g/dL, and albumin level of 2.3 ± 0.6 g/dL. Additionally, most patients had a low‐performance status (53% Eastern Cooperative Oncology Group 1/2, 44.8% Karnofsky score ≤80, and 61.2% Charlson Comorbidity Index ≥6). Emergency surgical complications were the main reasons for initial surgery (68%), with the majority attributed to fecal peritonitis (65.9%). Only 14.8% of patients achieved complete abdominal closure with an average of 24.8 days until closure. The in‐hospital mortality rate was 85.2%. Conclusion TAC is an alternative for oncological patients with surgical complications, but it carries a high mortality rate due to the compromised conditions of the patients.

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