Abstract：
BACKGROUND: Extended oncological resections for colorectal cancer surgery are associated with a high rate of complications, especially anastomotic leakage (AL). This study determines the incidence of risk factors for postoperative complications following cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for colorectal cancer (CRC).
METHODS: In this cohort study, the clinical data of all patients with CRC, treated with CRS and HIPEC, from 2011 to 2021 was analyzed. We considered patients\' characteristics, tumor-specific features, postoperative complications, and hospital stay using Chi-Square-test or Fisher\'s exact test. The Mann-Whitney-U-test was used to measure the probability of differences between two sets of data.
RESULTS: Of 1089 HIPEC procedures performed in the study center, 185 patients with CRC and peritoneal metastasis were treated with CRS and HIPEC after formation of at least one anastomosis and therefore included in this study. This included synchronous and metachronous peritoneal metastasis with a mean peritoneal cancer index of 8.67 ± 5.22. In this cohort, AL occurred in 12 (6.5 %) patients. There was no correlation between the number of anastomoses and the occurrence of an AL (p = 0.401).
CONCLUSIONS: This study reports a low risk of AL after CRS with HIPEC for CRC, comparable to other published data. If a complete cytoreduction seems possible, the risk of anastomotic leakage should not negatively influence the decision to resect. Further studies on this subject are essential to validate our findings.
METHODS: In this cohort study, the clinical data of all patients with CRC, treated with CRS and HIPEC, from 2011 to 2021 was analyzed. We considered patients\' characteristics, tumor-specific features, postoperative complications, and hospital stay using Chi-Square-test or Fisher\'s exact test. The Mann-Whitney-U-test was used to measure the probability of differences between two sets of data.
RESULTS: Of 1089 HIPEC procedures performed in the study center, 185 patients with CRC and peritoneal metastasis were treated with CRS and HIPEC after formation of at least one anastomosis and therefore included in this study. This included synchronous and metachronous peritoneal metastasis with a mean peritoneal cancer index of 8.67 ± 5.22. In this cohort, AL occurred in 12 (6.5 %) patients. There was no correlation between the number of anastomoses and the occurrence of an AL (p = 0.401).
CONCLUSIONS: This study reports a low risk of AL after CRS with HIPEC for CRC, comparable to other published data. If a complete cytoreduction seems possible, the risk of anastomotic leakage should not negatively influence the decision to resect. Further studies on this subject are essential to validate our findings.
摘要：
背景：结直肠癌手术的扩大肿瘤切除与高并发症发生率相关，尤其是吻合口漏(AL)。这项研究确定了结直肠癌（CRC）的细胞减灭术（CRS）和腹腔热化疗（HIPEC）后术后并发症的危险因素的发生率。
方法：在这项队列研究中，所有CRC患者的临床资料,用CRS和HIPEC治疗，从2011年到2021年进行了分析。我们考虑了患者的特征，肿瘤特异性特征，术后并发症,和住院时间使用卡方检验或Fisher精确检验。Mann-Whitney-U检验用于测量两组数据之间的差异概率。
结果：在研究中心进行的1089例HIPEC程序中，185例CRC和腹膜转移患者在至少一次吻合形成后接受CRS和HIPEC治疗，因此纳入本研究。这包括同步和异时腹膜转移，平均腹膜癌指数为8.67±5.22。在这个队列中，12例(6.5%)患者发生AL。吻合的数量与AL的发生之间没有相关性（p=0.401）。
结论：本研究报告，CRC合并HIPEC后AL的风险较低，与其他公布的数据相当。如果完全的细胞减少似乎是可能的，吻合口漏的风险不应影响切除的决定。对这一主题的进一步研究对于验证我们的发现至关重要。
方法：在这项队列研究中，所有CRC患者的临床资料,用CRS和HIPEC治疗，从2011年到2021年进行了分析。我们考虑了患者的特征，肿瘤特异性特征，术后并发症,和住院时间使用卡方检验或Fisher精确检验。Mann-Whitney-U检验用于测量两组数据之间的差异概率。
结果：在研究中心进行的1089例HIPEC程序中，185例CRC和腹膜转移患者在至少一次吻合形成后接受CRS和HIPEC治疗，因此纳入本研究。这包括同步和异时腹膜转移，平均腹膜癌指数为8.67±5.22。在这个队列中，12例(6.5%)患者发生AL。吻合的数量与AL的发生之间没有相关性（p=0.401）。
结论：本研究报告，CRC合并HIPEC后AL的风险较低，与其他公布的数据相当。如果完全的细胞减少似乎是可能的，吻合口漏的风险不应影响切除的决定。对这一主题的进一步研究对于验证我们的发现至关重要。
