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首页> 外文期刊>Surgical Endoscopy >A minimally invasive approach for peritonectomy procedures and hyperthermic intraperitoneal chemotherapy (HIPEC) in limited peritoneal carcinomatosis: The American Society of Peritoneal Surface Malignancies (ASPSM) multi-institution analysis
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A minimally invasive approach for peritonectomy procedures and hyperthermic intraperitoneal chemotherapy (HIPEC) in limited peritoneal carcinomatosis: The American Society of Peritoneal Surface Malignancies (ASPSM) multi-institution analysis

机译：腹膜切除术治疗的微创方法和高温腹膜内化疗（HIPEC）在有限的腹膜癌症中：美国腹膜表面恶性肿瘤（ASPSM）多机构分析

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BackgroundMinimally invasive surgery is playing an increasing role in the treatment of patients with gastrointestinal and gynaecological malignancies as the data show reduced morbidity, faster recovery and similar oncological outcome when compared to open procedures.Materials and methodsThe American Society of Peritoneal Surface Malignancies (ASPSM) conducted a retrospective study to analyse peritonectomy procedures and HIPEC done via the laparoscopic route. A database with standard clinical and pathological parameters was set up and distributed amongst ASPSM members. Rate of relapse, morbidity and mortality were the primary endpoints of the study.ResultsA total of 90 patients from 7 centres around the world were identified. Sixty percent were female. Mean age was 50years. Peritoneal carcinomatosis from appendiceal origin was the most common diagnosis in a 64.9% of patients and colon origin was diagnosed in 16.5% of patients. Mean peritoneal cancer index (PCI) was 4.1 (0-10). Forty-one percent of patients had a bowel resection. Mean operative time was 4.7h (2.5-8). All patients had a complete cytoreduction and HIPEC. Grade 3 and 4 morbidity was 3.0 and 6.5%, respectively. The most common reason for re-operation was an internal hernia in 2 out of 5 cases. Operative mortality and re-admission rates were 0 and 5%, respectively. Mean hospital stay was 7.4days (1-18). At a mean follow-up of 31.6months, 15/90 patients have a disease relapse but loco-regional relapse was identified in only five patients.ConclusionsAnalysis of these data suggests that minimally invasive approach for peritonectomy procedures and HIPEC is feasible, safe and should be considered as part of the armamentarium for highly selected patients with peritoneal surface malignancies with limited tumour burden, defined as PCI of 10 or less and borderline tumours as low-grade pseudomyxoma and benign multicystic mesothelioma.
机译：背景侵入性手术在治疗胃肠道和妇科恶性肿瘤患者时发挥着越来越大的作用，因为数据显示出与开放程序相比的发病率降低，更快的恢复和类似的肿瘤政治结果。在进行的美国腹膜表面（ASPSM）进行的美国人和方法通过腹腔镜路线分析腹膜切除术手术和高症的回顾性研究。建立了标准临床和病理参数的数据库，并分发了ASPSM成员。复发率，发病率和死亡率是研究的主要终点。鉴定了世界各地7个中心的90名患者的总和。六十个是女性。平均年龄为50年。来自阑尾原产地的腹膜癌是最常见的64.9％的患者，结肠血症患者被诊断为16.5％的患者。平均腹膜癌指数（PCI）是4.1（0-10）。 4％的患者患有肠切除术。平均手术时间为4.7h（2.5-8）。所有患者均有完全的细胞渗碳和高度。 3级和4级发病率分别为3.0％和6.5％。重新操作的最常见原因是2例中有2例内部疝气。手术死亡率和重新入学率分别为0和5％。平均住院入住时间为7.4天（1-18）。在平均随访31.6months，15/90名患者的疾病复发，但仅在五名患者中发现了疯狂的 - 区域复发。这些数据的链分析表明，腹膜切除程序和高症的微创方法是可行的，安全的，安全被认为是高度选定的腹膜表面恶性肿瘤患者的一部分，其肿瘤负担有限，定义为10或更少的PCI和濒影肿瘤，作为低级假瘤和良性多象性间皮瘤。

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