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首页> 外文期刊>Journal of Surgical Oncology >Gastric perforation following cytoreductive surgery with perioperative intraperitoneal chemotherapy.
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Gastric perforation following cytoreductive surgery with perioperative intraperitoneal chemotherapy.

机译：进行围手术期腹腔内化疗的细胞减少手术后的胃穿孔。

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OBJECTIVE: Gastrointestinal tract perforation after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has an incidence of 6%. The most common site is the small bowel. The trauma of CRS and delay in wound healing due to HIPEC has been thought to cause this complication. METHODS: From our database of 1,251 patients we recorded the treatments that resulted in a stomach perforation, the clinical manifestations, and the final outcome. We formulated a pathophysiology for the development of this postoperative complication. RESULTS: Four patients had postoperative gastrointestinal perforation limited to the wall of the stomach (incidence 0.3%). All patients underwent greater omentectomy with ligation of the gastroepiploic vessels on the surface of the greater curvature, received HIPEC and early perioperative intraperitoneal chemotherapy. All perforations occurred along the greater curvature of the stomach. Successful management of the perforation was by suture plication of the gastric defect. CONCLUSION: Perforation of the stomach following CRS and HIPEC likely results from vascular compromise, delay in wound healing from chemotherapy, seromuscular tears related to traction on the stomach wall and point pressure on the greater curvature from a long-term indwelling nasogastric tube. Reperitonealization of the greater curvature, if seromuscular tears occur, may help prevent this complication.
机译：目的：细胞减灭术（CRS）和腹腔热化疗（HIPEC）后的胃肠道穿孔发生率为6％。最常见的部位是小肠。人们认为，由HIPEC引起的CRS创伤和伤口愈合延迟会引起这种并发症。方法：从我们的1,251名患者的数据库中，我们记录了导致胃穿孔，临床表现和最终结果的治疗方法。我们为这种术后并发症的发展制定了病理生理学。结果：四例患者的胃肠道穿孔仅限于胃壁（发生率为0.3％）。所有患者均接受大网膜切除术，并结扎大曲率表面的胃表皮血管，接受HIPEC和围手术期早期腹膜内化疗。所有的穿孔都沿着胃的较大弯曲发生。通过缝合胃缺损可成功处理穿孔。结论：CRS和HIPEC后的胃穿孔可能是由于血管受损，化学疗法导致伤口愈合延迟，与胃壁牵引相关的血清肌撕裂以及长期留在鼻胃管上的较大弯曲点所致。如果发生血清肌性撕裂，较大曲率的腹膜化可能有助于预防这种并发症。

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