Research Article

Infectious Complications and Related Factors in the Treatment of Peritoneal Carcinomatosis from Colorectal Cancer Origin

  • Naciye Cigdem Arslan
  • Selman Sokmen
  • Vildan Avkan-oguz
  • Gulsen Atasoy
  • Tayfun Bisgin
  • Aras Emre Canda
  • Cem Terzi
  • Mehmet Fuzun

Turk J Colorectal Dis 2015;25(4):122-130

INTRODUCTION:

Aim of this study is to determine the prognostic factors associated with infectious complications after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in peritoneal carcinomatosis of colorectal cancer.

METHODS:

A prospectively collected database of patients who underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis of colorectal cancer in our center between December 2007 and December 2013 was reviewed. Indication/plan of the treatment was decided in the multidiciplinary oncology council. The aim of the surgery was complete macroscopic cytoreduction in all procedures. After cytoreduction proper chemotherapeutic agents were administered by closed abdominal hyperthermic intraperitoneal chemotherapy technic. Patients who underwent palliative surgery, patients with signs of active infection and immunosuppressive patients were excluded from the analysis. Complications and toxicity were classified according to “Common Terminology Criteria for Adverse Events” criteria. “The Centers for Disease Control and Prevention’s National Nosocomial Infections Surveillance System” definitions were used to identify postoperative nosocomial infections. Any materials clinically obtained were cultured routinely in the microbiological laboratory.

RESULTS:

Infectious complications are the most important cause of perioperative morbidity and mortality after cytoreducitve surgery and hyperthermic intraperitoneal chemotherapy. Tumor burden, agressive and prolonged surgery as well as patient performance play an eminent role on infectious morbidity. Patients with peritoneal carcinomatosis of colorectal cancer should be considered as a complex oncologic group sensitive to infectious complications. Multidisciplinary approach will contribute to easiness in management of infectious complications.

DISCUSSION AND CONCLUSION:

Infectious complications are the most important cause of perioperative morbidity and mortality after cytoreducitve surgery and hyperthermic intraperitoneal chemotherapy. Tumor burden, agressive and prolonged surgery as well as patient performance play an eminent role on infectious morbidity. Patients with peritoneal carcinomatosis of colorectal cancer should be considered as a complex oncologic group sensitive to infectious complications. Multidisciplinary approach will contribute to easiness in management of infectious complications.

Keywords: Colorectal cancer, Peritoneal neoplasms, Regional Perfusion Cancer Chemotherapy, Postoperative complications, Hospital infections