HIPEC, Gastro Intestinal Cancer, Adhesion Prevention, Bowel Functions
Conditions
Brief summary
This retrospective cohort study was conducted at our institution, involving patients with gastric cancer, appendiceal mucinous neoplasm, or colon cancer who underwent CRS with or without HIPEC between January 2017 and December 2023. Patient selection criteria would include all the following: 1) Karnofsky performance status (KPS) score \>50; 2) stage T4b (American Joint Committee on Cancer \[AJCC\] 8th edition stage) or peritoneal metastasis was confirmed during or after surgery; 3) life expectancy \>3 months; 4) peripheral white blood cell count ≥3,500/mm3 and platelet count ≥80,000/mm3; and 5) acceptable liver, renal, cardiovascular, pulmonary, and coagulation function, and other major organ functions were able to endure a major operation. The exclusion criteria were defined as follows: 1) Performance of emergency surgery due to intestinal obstruction or perforation; 2) a history of inflammatory bowel disease (IBD); 3) two or more independent surgical procedures on the gastrointestinal tract; and 4) who received postoperative enema. Patients were divided into two groups based on the treatment strategy: (1) surgery alone (No-HIPEC group); (2) surgery combined with HIPEC (HIPEC group).
Interventions
HIPEC was performed after gastrectomy or hemicolectomy, alimentary tract reconstruction and wound closure. Catheters, including the inflow and outflow tubes, were crossly placed into the abdominal cavity prior to primary abdominal closure. The temperature probes were placed on the inflow and outflow catheter tips. HIPEC was administered for 1 hour with an automatic HIPEC device (Thermochem НТ-1000 (ThermaSolutions, Inc., USA)). Perfusate used was Ringer's solution (5-6 L) mixed with cisplatin 50 mg/m2, 5-fluorouracil 500mg/m2 or raltitrexed 3 mg/m2, and warmed to an inflow temperature of 44 ℃.
Sponsors
Peking University People's Hospital
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Clinical diagnosis of gastric, appendiceal, or colon malignant tumors of stage T4b or peritoneal metastases; * Karnofsky performance status (KPS) score \>50; * Life expectancy \>3 months; * Peripheral white blood cell count ≥3,500/mm3 and platelet count ≥80,000/mm3; * Acceptable liver, renal, cardiovascular, pulmonary, and coagulation function, and other major organ functions were able to endure a major operation.
Exclusion criteria
* Emergency surgery due to intestinal obstruction or perforation; * A history of inflammatory bowel disease (IBD); * Two or more independent surgical procedures on the gastrointestinal tract; * Postoperative enema.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Time to first defecation after surgery | Perioperative |
| Length of postoperative stay | Perioperative |
Secondary
| Measure | Time frame |
|---|---|
| Incidence of postoperative complications | Perioperative |
Countries
China
Outcome results
None listed