Surgical oncology · 2026
Improving surgical management of patients with extensive peritoneal metastases using damage control techniques.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Arvieux Catherine, Dumont Frédéric, Sourrouille Isabelle, Quesada Jean-Louis, Sage Pierre-Yves, Michy Thierry, Bernard Juliette, Fischer Juliette, Tuech Jean-Jacques, Tidadini Fatah
Аннотация
INTRODUCTION: Damage control surgery (DCS) is a well-established standard of management for severe abdominal trauma which has been developed as a rescue technique to prevent Abdominal Compartment Syndrome. DCS is also widely used for non-trauma patients and in some cases for patients undergoing cytoreductive surgery. We aim to evaluate the benefits of DCS following CRS with or without HIPEC in a curative intent with a decision of two-stage surgery.
METHODS: Between July 2016 to January 2024, 16 patients with a decision for planned reintervention just before or during the initial surgery were included in 4 expert centers. Patients were optimally resuscitated for 6 to 72 h depending on the clinical-biological context and the initial DCS indication (Step1-SURG), and then underwent second-look surgery (Step2-SURG).
RESULTS: The median age was 57.5 [45.5; 64] years. The origin of carcinomatosis was pseudomyxoma (12), ovarian (2), appendicular (1) or rectal (1), and 9 underwent HIPEC. Median PCI score was 30.5. The median length of surgery was 550 min for the Step1-SURG and 240 min for the Step2-SURG, with a median delay of 1.5 days. Severe complication rates were respectively, 50% and 69%. 1 (6.25%) patient died after the Step2-SURG. The median OS and RFS were 51.3 and 27.7 months respectively, all etiologies combined.
CONCLUSIONS: Our results suggest a two-stage approach based on damage-control principles may be feasible in selected patients undergoing extensive CRS/HIPEC in expert centers. However, further studies with clearer selection criteria and comparative cohorts are needed.
METHODS: Between July 2016 to January 2024, 16 patients with a decision for planned reintervention just before or during the initial surgery were included in 4 expert centers. Patients were optimally resuscitated for 6 to 72 h depending on the clinical-biological context and the initial DCS indication (Step1-SURG), and then underwent second-look surgery (Step2-SURG).
RESULTS: The median age was 57.5 [45.5; 64] years. The origin of carcinomatosis was pseudomyxoma (12), ovarian (2), appendicular (1) or rectal (1), and 9 underwent HIPEC. Median PCI score was 30.5. The median length of surgery was 550 min for the Step1-SURG and 240 min for the Step2-SURG, with a median delay of 1.5 days. Severe complication rates were respectively, 50% and 69%. 1 (6.25%) patient died after the Step2-SURG. The median OS and RFS were 51.3 and 27.7 months respectively, all etiologies combined.
CONCLUSIONS: Our results suggest a two-stage approach based on damage-control principles may be feasible in selected patients undergoing extensive CRS/HIPEC in expert centers. However, further studies with clearer selection criteria and comparative cohorts are needed.