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1.
World J Clin Cases ; 9(18): 4644-4653, 2021 Jun 26.
Article in English | MEDLINE | ID: mdl-34222431

ABSTRACT

BACKGROUND: Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) has shown promising results in improving the survival of ovarian cancer patients. Although the safety profiles of CRS-HIPEC exist, more attention should be paid to gastrointestinal complications, as the procedure involves a considerable proportion of bowel resection and anastomosis. AIM: To identify the risk factors for delayed gastric emptying in ovarian cancer treated with CRS-HIPEC. METHODS: A cross-sectional study was conducted. According to the inclusion and exclusion criteria, we retrospectively analyzed 77 patients admitted between March 2014 and April 2018 with advanced and recurrent ovarian cancer treated with CRS-HIPEC in Beijing Shijitan Hospital of Capital Medical University. Risk factors for delayed gastric emptying were analyzed using univariate analysis. All of the statistically significant variables in the univariate analysis were entered into the multivariable logistic regression model to determine factors independently associated with delayed gastric emptying. RESULTS: Among the 77 included patients, 36.4% (28/77) had delayed gastric emptying after CRS-HIPEC. The median age and body mass index of all patients were 59 years and 22.83 kg/m2, respectively. Preoperative chemotherapy was administered in 55 patients (71%). Sixty-two patients (81%) had a history of at least one previous pelvic surgery. The median operation time and intraoperative hemorrhage volume were 630 min and 600 mL, respectively. Omentectomy was performed in 32 cases of primary ovarian cancer and 24 cases of recurrence. The median peritoneal cancer index was 16. The risk factors for delayed gastric emptying from the univariate analysis were body mass index < 23 kg/m2 (X 2 = 5.059, P = 0.025), history of pelvic surgery (X 2 = 4.498, P = 0.034), history of chemotherapy (X 2 = 4.334, P = 0.037), operation time ≥ 7 h (X 2 = 4.827, P = 0.047), and intraoperative hemorrhage ≥ 800 mL (X 2 = 7.112, P = 0.008). Multivariable analysis revealed that age ≥ 70 years (HR = 7.127; 95%CI 1.122-45.264; P = 0.037) and intraoperative hemorrhage ≥ 800 mL (HR = 3.416; 95%CI 1.067-10.939; P = 0.039) were independently associated with postoperative delayed gastric emptying after CRS-HIPEC. CONCLUSION: Postoperative gastrointestinal management, including prolonged nasogastric intubation, should be promoted for patients over 70 years or those with intraoperative bleeding exceeding 800 mL.

2.
Ann Palliat Med ; 10(1): 385-391, 2021 Jan.
Article in English | MEDLINE | ID: mdl-33545771

ABSTRACT

BACKGROUND: Pleural effusion (PE) is one of the most common complications of advanced recurrent ovarian cancer. However, no studies have revealed the risk factors for PE after surgery. The purpose of this study is to observe the incidence and risk factors of PE after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with late-stage and recurrent ovarian cancer. METHODS: A retrospective analysis of 77 patients with late-stage and recurrent ovarian cancer after CRS + HIPEC was conducted. According to the presence of PE within 7 days after operation, two groups were formed. The basic information, surgical process, and laboratory examinations of the two groups were analyzed and compared to conduct a regression analysis. RESULTS: The incidence of postoperative PE was 57.1% (44/77 patients). Among these patients, the prevalence of grade I-II and grade III-IV PE was 42.8% (33/77 patients) and 14.3% (11/77 patients), respectively. There were statistically significant differences between the two groups in terms of preoperative PE, the duration of surgery, intraoperative blood loss, postoperative level of albumin, intestinal involvement, and diaphragmatic involvement. Among these, preoperative PE and diaphragmatic involvement were identified as independent risk factors of postoperative PE. CONCLUSIONS: Patients with late-stage and recurrent ovarian cancer invariably develop postoperative PE after CRS + HIPEC. Preoperative PE and diaphragmatic involvement are independent risk factors of postoperative PE. It is estimated that the incidence of postoperative PE among patients with these two independent risk factors is approximately 100%. Hence, we should promote the prevention and treatment of PE to improve its prognosis.


Subject(s)
Hyperthermia, Induced , Ovarian Neoplasms , Peritoneal Neoplasms , Pleural Effusion , Combined Modality Therapy , Cytoreduction Surgical Procedures/adverse effects , Female , Humans , Hyperthermia, Induced/adverse effects , Hyperthermic Intraperitoneal Chemotherapy , Ovarian Neoplasms/drug therapy , Peritoneal Neoplasms/drug therapy , Pleural Effusion/etiology , Retrospective Studies , Risk Factors
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