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Gastroenterology Research and Practice
Volume 2012 (2012), Article ID 836425, 5 pages
http://dx.doi.org/10.1155/2012/836425
Clinical Study

Morbidity and Mortality Outcomes of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy at a Single Institution in Japan

1Department of Surgery, Kusatsu General Hospital, Yabase Kusatsu 1660, Japan
2General Surgery Clinic, Kocaeli Derince Education and Research Hospital, Kocaeli, Turkey
3NPO Organization to Support Peritoneal Dissemination Treatment, Osaka, Japan

Received 2 March 2012; Revised 24 April 2012; Accepted 3 May 2012

Academic Editor: Yan Li

Copyright © 2012 Akiyoshi Mizumoto et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Even though cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are associated with a high morbidity and mortality rates, it has been reported that CRS and HIPEC improved survival of selected patients with peritoneal carcinomatosis. We aimed to report morbidity and mortality results of CRS and HIPEC from a single institution in Japan. Methods and Results. Total of 284 procedures of CRS were performed on patients with pseudomyxoma peritonei, peritoneal carcinomatosis (PC) from colon cancer and gastric cancer between 2007 and 2011 in our institution. The morbidity rate was 49% of all procedure, and grades I/II and grades III/IV complications were 28% and 17%, respectively. Most frequent complication was surgical site infections including intraabdominal abscess. The mortality rate was 3.5%, and reoperation was needed in 11% of all procedures. Univariate and multivariate analysis showed peritoneal carcinomatosis index (PCI) greater than 20 was the only significant factor for occurrence of postoperative complications ( 𝑃 < 0 . 0 1 ). In contrast, HIPEC significantly reduced postoperative complications ( 𝑃 < 0 . 0 5 ). Conclusions. The morbidity and mortality rates of our institution are comparable with previous reports that are in acceptable rates. Optimal patient selection such as patients with PCI less than 20 seems to be of paramount importance to CRS and HIPEC.