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Water lavage as an adjunct to cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC).
Gabriel, Emmanuel; Singla, Smit; Kim, Minhyung; Fisher, Daniel; Powers, Colin; Visioni, Anthony; Attwood, Kristopher; Skitzki, Joseph.
Afiliación
  • Gabriel E; Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, NY, USA.
  • Singla S; Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, NY, USA.
  • Kim M; Department of Immunology, Roswell Park Cancer Institute, Buffalo, NY, USA.
  • Fisher D; Department of Immunology, Roswell Park Cancer Institute, Buffalo, NY, USA.
  • Powers C; Department of Immunology, Roswell Park Cancer Institute, Buffalo, NY, USA.
  • Visioni A; Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, NY, USA.
  • Attwood K; Department of Biostatistics, Roswell Park Cancer Institute, Buffalo, NY, USA.
  • Skitzki J; Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, NY, USA. Electronic address: Joseph.Skitzki@RoswellPark.org.
Am J Surg ; 214(3): 462-467, 2017 Sep.
Article en En | MEDLINE | ID: mdl-28622839
BACKGROUND: Water lavage (WL) during gastrointestinal cancer surgery has osmotically mediated lytic effects on tumor cells. We investigated the safety and efficacy of WL with CRS-HIPEC. METHODS: This is a retrospective review, 1/2003-7/2014, of a single institution experience with CRS-HIPEC comparing patients who had WL (WL+) to those who did not (WL-). RESULTS: Of 157 CRS-HIPECs, 16 (10.2%) were WL+. WL+ had more PCI scores >20 compared to WL- (56.3% vs 19.4%, respectively, p = 0.003); however, the completeness of cytoreduction (CC) was similar. There were no differences in hospital length of stay or post-operative complications. The average POD 1 sodium (Na) level was statistically lower in the WL+ group (133.6 ± 2.5 vs 135.5 ± 3.2 mEq/L, p = 0.023); however, the average Na at discharge for each group was 140 mEq/L. There were no differences in 3-year OS (3WL+:0.63 vs WL-:0.68, p = 0.97) or RFS (WL+:0.32 vs WL-:0.39, p = 0.47). A subset analysis for patients with PCI >20 showed no difference between groups. CONCLUSIONS: WL offers a low cost, safe and theoretically efficacious method of tumor cell lysis for peritoneal malignancy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Peritoneales / Quimioterapia del Cáncer por Perfusión Regional / Procedimientos Quirúrgicos de Citorreducción / Hipertermia Inducida Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Am J Surg Año: 2017 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Peritoneales / Quimioterapia del Cáncer por Perfusión Regional / Procedimientos Quirúrgicos de Citorreducción / Hipertermia Inducida Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Am J Surg Año: 2017 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos