Morbidity, mortality, and ICU stay after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

Abstract

Aim: Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is a comprehensive treatment approach for primary peritoneal cancers and peritoneal metastases from colorectal, appendiceal, ovarian, gastric, and other malignancies. This study aimed to evaluate clinical outcomes, perioperative complications, and their impact on morbidity and mortality in patients undergoing CRS and HIPEC. Methods :A retrospective analysis was conducted on patients who underwent CRS and HIPEC. Demographic characteristics, primary diagnoses, comorbidities, laboratory findings, surgical details, and chemotherapeutic agents were recorded. Perioperative hemodynamic changes, fluid and blood product use, need for postoperative intensive care and mechanical ventilation, and renal injury were assessed. ICU stay duration and mortality rates were documented. Results: A total of 41 patients were included. The most common primary diagnosis was ovarian cancer (65.9%), followed by colon cancer (17.1%) and mesothelioma (14.6%). Chemotherapeutic agents administered included cisplatin (78%), paclitaxel (46.3%), doxorubicin (14.6%), oxaliplatin (14.6%), and 5-FU (12.2%). Most patients (87.8%) were extubated postoperatively, and 90.2% required ICU follow-up. The mean ICU stay was 4.3 +/- 1.5 days. Acute kidney injury occurred in 21.9% of patients. One-month postoperative mortality was 12.2%, and total mortality at 15 months was 24.4%. Conclusion: CRS and HIPEC are associated with significant perioperative physiological changes. Successful outcomes require meticulous perioperative management, particularly in terms of hemodynamic stability and organ function support.