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Predictors of Anastomotic Failure After Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: Does Technique Matter?

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Predictors of Anastomotic Failure After Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: Does Technique Matter? Annals of surgical oncology Wiseman, J. T., Kimbrough, C. n., Beal, E. W., Zaidi, M. Y., Staley, C. A., Grotz, T. n., Leiting, J. n., Fournier, K. n., Lee, A. J., Dineen, S. n., Powers, B. n., Veerapong, J. n., Baumgartner, J. M., Clarke, C. n., Patel, S. H., Dhar, V. n., Hendrix, R. J., Lambert, L. n., Abbott, D. E., Pokrzywa, C. n., Raoof, M. n., Lee, B. n., Fackche, N. n., Greer, J. n., Pawlik, T. M., Abdel-Misih, S. n., Cloyd, J. M. 2019

Abstract

Anastomotic failure (AF) after cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) remains a dreaded complication. Whether specific factors, including anastomotic technique, are associated with AF is poorly understood.Patients who underwent CRS-HIPEC including at least one bowel resection between 2000 and 2017 from 12 academic institutions were reviewed to determine factors associated with AF (anastomotic leak or enteric fistula).Among 1020 patients who met the inclusion criteria, the median age was 55 years, 43.9% were male, and the most common histology was appendiceal neoplasm (62.3%). The median Peritoneal Cancer Index was 14, and 93.2% of the patients underwent CC0/1 resection. Overall, 82 of the patients (8%) experienced an AF, whereas 938 (92.0%) did not. In the multivariable analysis, the factors associated with AF included male gender (odds ratio [OR], 2.2; p??0.05). Anastomotic failure was associated with longer hospital stay (23 vs 10 days; p?

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