Ureteral Stenting in Cytoreductive Surgery plus Hyperthermic Intraperitoneal Chemotherapy as a Routine Procedure: Evidence and Necessity

被引:14
作者
Coccolini, Federico [1 ]
Lotti, Marco [1 ]
Manfredi, Roberto [1 ]
Catena, Fausto [4 ]
Vallicelli, Carlo [4 ]
De Iaco, Pier Andrea [5 ]
Da Pozzo, Luigi [2 ]
Frigerio, Luigi [3 ]
Ansaloni, Luca [1 ]
机构
[1] Osped Riuniti Bergamo, Gen & Emergency Surg Dept, IT-24128 Bergamo, Italy
[2] Osped Riuniti Bergamo, Dept Urol, IT-24128 Bergamo, Italy
[3] Osped Riuniti Bergamo, Dept Obstet & Gynecol, IT-24128 Bergamo, Italy
[4] St Orsola Malpighi Univ Hosp, Dept Gen & Transplant Surg, Bologna, Italy
[5] St Orsola Malpighi Univ Hosp, Dept Obstet & Gynecol, Bologna, Italy
关键词
Hyperthermic intraperitoneal chemotherapy; Chemotherapy; Ureteral stent; Cytoreduction surgery; Cancer; URINARY-TRACT INJURY; RENAL-TRANSPLANTATION; GYNECOLOGIC SURGERY; CATHETERS; HYSTERECTOMY; MANAGEMENT;
D O I
10.1159/000339920
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Introduction: There is a need for more exhaustive data concerning the use of prophylactic ureteral stenting for extended debulking and cytoreductive procedures in the literature. Material and Methods: A retrospective analysis of the CARPEPACEM study protocol database was performed. The trial protocol schedules the positioning of bilateral ureteral stents before cytoreductive surgery + hyperthermic intraperitoneal chemotherapy (HIPEC). Results: Fifty-one operated patients: 31 (59.6%) with peritoneal dissemination from ovarian cancer, 8 (15.3%) from colorectal cancer, 4 (7.9%) from pseudomyxoma peritonei, 3 (5.7%) from gastric cancer, 2 (3.8%) from peritoneal mesothelioma, 1 (1.9%) from appendiceal cancer, 1 (1.9%) from endometrial cancer, and 1 (1.9%) from leiomyosarcoma. Mean and median peritoneal cancer index: 11 and 10 (range: 0-28). CC-score: CC-0 in 45 (86.5%) patients, CC-1 in 5 (9.6%) and CC-2 in 1 (1.9%). HIPEC was performed with platinum + taxol in 22 patients (42.3%), plati-num + adriablastin in 10 (19.2%), mitomycin in 9 (17.3%), platinum + mitomycin in 7 (13.4%), platinum + doxorubicin in 2 (3.8%), and taxol + adriablastin in 1 (1.9%). Two major ureteral complications were observed (3.9%). Discussion: Prophylactic ureteral stenting could reduce the risk of postoperative ureteral complications without an increase in stent placement-related complications; however, a randomized clinical trial is needed. Copyright (C) 2012 S. Karger AG, Basel
引用
收藏
页码:307 / 310
页数:4
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