Titre :

Half of Postoperative Deaths After Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy Could be Preventable

Auteur(s) :

Houlzé-Laroye, Constance [Auteur]
Hôpital Claude Huriez [Lille]
Glehen, Olivier [Auteur]
Centre Hospitalier Lyon Sud [CHU - HCL] [CHLS]
Sgarbura, Olivia [Auteur]
UNICANCER - Institut régional du Cancer Montpellier Val d'Aurelle [ICM]
Gayat, Etienne [Auteur]
Marqueurs cardiovasculaires en situation de stress [MASCOT (UMR_S_942 / U942)]
Service de Réanimation Médicale et Toxicologique [Hôpital Lariboisière]
Optimisation thérapeutique en Neuropsychopharmacologie [OPTeN (UMR_S 1144 / U1144)]
Centre hospitalier Saint-Joseph [Paris]
Sourrouille, Isabelle [Auteur]
Département de chirurgie viscérale [Gustave Roussy]
Tuech, Jean-Jacques [Auteur]
Service de Chirurgie Digestive [CHU Rouen]
Delhorme, Jean-Baptiste [Auteur]
Interface de Recherche Fondamentale et Appliquée en Cancérologie [IRFAC - Inserm U1113]
Dumont, Frédéric [Auteur]
Territoires, Villes, Environnement & Société - ULR 4477 [TVES]
Université de Lille
Ceribelli, Cécilia [Auteur]
Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy] [UNICANCER/ICL]
Amroun, Koceila [Auteur]
Hôpital Robert Debré
Arvieux, Catherine [Auteur]
Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
Moszkowicz, David [Auteur]
Maladies et hormones du système nerveux [DHNS]
Pirro, Nicolas [Auteur]
Hôpital de la Timone [CHU - APHM] [TIMONE]
Lefevre, Jérémie [Auteur]
CHU Saint-Antoine [AP-HP]
Courvosier-Clement, Thomas [Auteur]
Centre hospitalier universitaire de Poitiers = Poitiers University Hospital [CHU de Poitiers [La Milétrie]]
Paquette, Brice [Auteur]
Service de Chirurgie Digestive [CHRU Besançon]
Mariani, Pascale [Auteur]
Institut Curie [Paris]
Pezet, Denis [Auteur]
Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte [M2iSH]
Sabbagh, Charles [Auteur]
CHU Amiens-Picardie
Simplification des soins chez les patients complexes - UR UPJV 7518 [SSPC]
Tessier, Williams [Auteur]
Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] [UNICANCER/Lille]
Celerier, Bertrand [Auteur]
Guilloit, Jean-Marc [Auteur]
Taibi, Abdelkader [Auteur]
XLIM [XLIM]
CHU Limoges
Quenet, François [Auteur]
Bakrin, Naoual [Auteur]
Pocard, Marc [Auteur]
Goéré, Diane [Auteur]
Brigand, Cécile [Auteur]
Piessen, Guillaume [Auteur]
Eveno, Clarisse [Auteur]

Titre de la revue :

Annals of Surgery

Pagination :

797-804

Éditeur :

Lippincott, Williams & Wilkins

Date de publication :

2021-11-29

ISSN :

0003-4932

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

Objective: To perform a retrospective root-cause analysis of postoperative death after CRS and HIPEC procedures. Background: The combination of CRS and HIPEC is an effective therapeutic strategy to treat peritoneal surface ...
Lire la suite >Objective: To perform a retrospective root-cause analysis of postoperative death after CRS and HIPEC procedures. Background: The combination of CRS and HIPEC is an effective therapeutic strategy to treat peritoneal surface malignancies, however it is associated with significant postoperative mortality. Methods: All patients treated with a combination of CRS and HIPEC between January 2009 and December 2018 in 22 French centers and died in the hospital, were retrospectively analyzed. Perioperative data of the 101 patients were collected by a local senior surgeon with a sole junior surgeon. Three independent experts investigated the typical root cause of death and provided conclusions on whether postoperative death was preventable (PREV group) or not (NON-PREV group). A typical root cause of preventable postoperative death was classified on a cause-and-effect diagram. Results: Of the 5562 CRS+HIPEC procedures performed, 101 in-hospital deaths (1.8%) were identified, of which a total of 18 patients of 70 years old and above and 20 patients with ASA score of 3. Etiology of peritoneal disease was mainly colorectal. A total of 54 patients (53%) were classified in the PREV group and 47 patients (47%) in the NON-PREV group. The results of the study show that in the PREV group, WHO performance status 1-2 was more frequent and the Median Peritoneal Cancer Index was higher compared with those of the NON-PREV group. The cause of death in the PREV group was classified as: (i) preoperatively for debatable indication (59%), (ii) intraoperatively (30%) and (iii) postoperatively in 17 patients (31%). A multifactorial cause of death was found in 11 patients (20%). Conclusion: More than half of the postoperative deaths after combined CRS and HIPEC may be preventable, mainly by following guidelines regarding preoperative selection of the patients and adequate intraoperative decisions.Lire moins >

Langue :

Anglais

Vulgarisation :

Non

Collections :

• Territoires, Villes, Environnement & Société (TVES) - ULR 4477

Source :

Harvested from HAL