Academic Journal
Laparoscopic cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for perforated low-grade appendiceal mucinous neoplasms
| العنوان: | Laparoscopic cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for perforated low-grade appendiceal mucinous neoplasms |
|---|---|
| المؤلفون: | Abudeeb, Haytham, Selvasekar, Chelliah R., O’Dwyer, Sarah T., Chakrabarty, Bipasha, Malcolmson, Lee, Renehan, Andrew G., Wilson, Malcolm S., Aziz, Omer |
| المصدر: | Abudeeb , H , Selvasekar , C R , O’Dwyer , S T , Chakrabarty , B , Malcolmson , L , Renehan , A G , Wilson , M S & Aziz , O 2020 , ' Laparoscopic cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for perforated low-grade appendiceal mucinous neoplasms ' , Surgical Endoscopy , vol. 34 , no. 12 , pp. 5516-5521 . https://doi.org/10.1007/s00464-019-07349-x |
| سنة النشر: | 2020 |
| المجموعة: | The University of Manchester: Research Explorer - Publications |
| مصطلحات موضوعية: | Cytoreductive surgery, Hyperthermic intraperitoneal chemotherapy, Laparoscopic, Low-grade appendiceal mucinous neoplasms, ResearchInstitutes_Networks_Beacons/mcrc, name=Manchester Cancer Research Centre |
| الوصف: | INTRODUCTION: Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) is an established treatment for pseudomyxoma peritonei (PMP) from perforated low-grade appendiceal mucinous neoplasms (LAMN II). In a selected group of LAMN II patients without established PMP, CRS/HIPEC can be performed laparoscopically (L-CRS/HIPEC); however the short-term benefits and safety of this approach have yet to be determined. This study aims to determine the short-term outcomes from a series of L-CRS/HIPEC LAMN II patients compared to those who have undergone a similar open operation (O-CRS/HIPEC) for low-volume PMP. METHODS: LAMN II patients undergoing L-CRS/HIPEC at a UK national peritoneal tumour centre were compared to O-CRS/HIPEC patients (peritoneal cancer index ≤ 7). Outcomes of interest included Clavien-Dindo complication grade, operative time, blood transfusions, high dependency unit (HDU) admission, length of hospital stay, and histopathological findings. RESULTS: 55 L-CRS/HIPEC were compared to 29 O-CRS/HIPEC patients (2003-2017). Groups were matched for age, sex, and procedures. Median operative time was 8.8 (IQR 8.1-9.5) h for L-CRS/HIPEC versus 7.3 (IQR 6.7-8) h for O-CRS/HIPEC (Mann-Whitney test p < 0.001). Post-operative HDU admission was 56% versus 97% (OR 0.04 95% CI 0.01-0.34) and median length of stay = 6 (IQR 5-8) versus 10 (IQR 8-11) days (p < 0.001) for L- versus O-CRS/HIPEC. Despite a normal pre-operative CT scan, 13/55 (23.6%) L-CRS/HIPEC patients had acellular mucin and 2/55 (3.5%) had mucin with epithelium present in their specimens. Residual appendix tumour was identified in 2/55 patients (3.6%). Clavien-Dindo Grade 1-4 complications were similar in both groups with no mortality. CONCLUSION: L-CRS/HIPEC for LAMN II takes longer; however patients have significantly reduced length of HDU and overall stay, without increased post-operative complications. A significant proportion of LAMN II patients undergoing L-CRS/HIPEC have extra-appendiceal acellular mucin with some cases ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| Relation: | https://research.manchester.ac.uk/en/publications/25931311-1c60-4c72-91c9-12d29f50ed6a |
| DOI: | 10.1007/s00464-019-07349-x |
| الاتاحة: | https://research.manchester.ac.uk/en/publications/25931311-1c60-4c72-91c9-12d29f50ed6a https://doi.org/10.1007/s00464-019-07349-x http://www.scopus.com/inward/record.url?scp=85078456949&partnerID=8YFLogxK |
| Rights: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.B921A5F5 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1007/s00464-019-07349-x |
|---|