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Acta Chir Belg ; 118(6): 348-353, 2018 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-29475412

RESUMEN

BACKGROUND: Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is associated with significant manipulation of the urinary tract (UT). We aim to describe the urological events and their management in patients who underwent CRS-HIPEC. METHODS: Clinical records of patients who underwent treatment between 2007 and 2015 were reviewed. Urological events and their multidisciplinary management were analyzed. Descriptive statistics were calculated. RESULTS: A total of 103 patients were included. Mean age was 51 years (SD ± 11.8). Mean peritoneal cancer index (PCI) was 20.4 (SD ± 10.1). Primary tumors included appendicular (64%), gynecological (16%), colorectal (10%), and peritoneal mesotheliomas (9%). Ninety-three percent of patients had bilateral ureteral catheters inserted prior to surgery, without complications. Intraoperative UT injuries occurred in 7% of patients. In 5% of patients, tumor invasion of the bladder was evident at surgery and partial resection and primary repair of the bladder wall was performed. Urological complications included urinary tract infection (UTI) (21%) acute post-renal failure (4%), urinary fistulae (4%), and acute urinary retention (AUR) (1%). CONCLUSIONS: In our study, intraoperative UT events and postoperative complications, although not neglectable, were infrequent. Due to the high complexity of these cases, a multidisciplinary approach is mandatory. However, randomized clinical trials are necessary to clarify current data on the need and efficacy of prophylactic ureteral catheterization in patients undergoing CRS-HIPEC.


Asunto(s)
Procedimientos Quirúrgicos de Citorreducción/efectos adversos , Hipertermia Inducida/métodos , Neoplasias Peritoneales/patología , Neoplasias Peritoneales/terapia , Sistema Urinario/lesiones , Enfermedades Urológicas/etiología , Adulto , Anciano , Terapia Combinada , Procedimientos Quirúrgicos de Citorreducción/métodos , Bases de Datos Factuales , Femenino , Humanos , Enfermedad Iatrogénica/epidemiología , Incidencia , Masculino , Persona de Mediana Edad , Invasividad Neoplásica/patología , Estadificación de Neoplasias , Neoplasias Peritoneales/mortalidad , Complicaciones Posoperatorias/fisiopatología , Complicaciones Posoperatorias/terapia , Estudios Retrospectivos , Medición de Riesgo , Análisis de Supervivencia , Cateterismo Urinario/efectos adversos , Cateterismo Urinario/métodos , Enfermedades Urológicas/fisiopatología , Enfermedades Urológicas/terapia
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