Coagulation after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: a retrospective cohort analysis

AbstractPurposeCytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) benefit patients with peritoneal carcinomatosis. Nevertheless, this therapy is associated with considerable postoperative pain due to the extensive abdominal incision. While epidural analgesia offers efficacious pain control, CRS and HIPEC therapy is associated with perioperative coagulopathy that may impact its use. The purpose of this retrospective study is to characterize the postoperative coagulopathy in this patient subset and to develop a model that will help predict those at risk.MethodsOur database of patients treated with CRS and HIPEC (n = 171) was reviewed to assess perioperative changes in platelet count, international normalized ratio (INR), and partial thromboplastin time (PTT). Abnormal coagulation was defined by platelet count 60 sec. A logistic regression model was developed to determine if patient, disease, and/or surgical factor(s) were associated with the development of postoperative coagulopathy. Epidural catheter management in this patient population was also reviewed.ResultsSignificant differences (adjustedP
Source: Canadian Journal of Anesthesia - Category: Anesthesiology Source Type: research

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CONCLUSIONS: GL-ONC1 was well tolerated when administered into the peritoneal cavity of patients with advanced stage PC. Efficient tumor cell infection, in-patient virus replication as well as onco-lysis were limited to treatment cycle 1. (ClinicalTrials.gov number, NCT01443260). PMID: 29773661 [PubMed - as supplied by publisher]
Source: Clinical Cancer Research - Category: Cancer & Oncology Authors: Tags: Clin Cancer Res Source Type: research
ConclusionSymptoms of TB may vary and findings can be misleading. An interdisciplinary approach is needed for diagnosis and treatment.
Source: Journal of Gastrointestinal Surgery - Category: Surgery Source Type: research
CONCLUSIONS: PIPAC with cisplatin and doxorubicin may be safely used at an intraperitoneal dose of 10.5 mg/m2 and 2.1 mg/m2, respectively. Systemic toxicity of this therapy is low. PMID: 29743140 [PubMed - as supplied by publisher]
Source: Gynecologic Oncology - Category: Cancer & Oncology Authors: Tags: Gynecol Oncol Source Type: research
A 51-year old male patient presented with lower abdominal pain persisting since about one year. Abdominal computed tomography scan showed a solid tumor interpreted as urachal carcinoma with peritoneal carcinomatosis. Histopathological examination revealed urachal abscess. Awareness of clinical signs and imaging findings of this rare but characteristic condition may avoid emotional distress of patients associated with erroneous suspicion of malignancy.
Source: Urology - Category: Urology & Nephrology Authors: Tags: Images in Clinical Urology Source Type: research
A 51-year-old male patient presented with lower abdominal pain persisting since about 1 year. Abdominal computed tomography scan showed a solid tumor interpreted as urachal carcinoma with peritoneal carcinomatosis. Histopathological examination revealed urachal abscess. Awareness of clinical signs and imaging findings of this rare but characteristic condition may avoid emotional distress of patients associated with erroneous suspicion of malignancy.
Source: Urology - Category: Urology & Nephrology Authors: Tags: Images in Clinical Urology Source Type: research
Abstract Dural metastasis from primary gastric adenocarcinoma has been rarely reported, and its prognosis is very poor because it frequently leads to acute subdural hematoma. Here, we describe a case with sequential spinal and cranial dural metastases from gastric adenocarcinoma without subdural hematoma. A 43-year-old woman with gastric adenocarcinoma and well-controlled peritoneal carcinomatosis presented with back pain, right radiating leg pain, left facial palsy, and hearing loss. Magnetic resonance imaging of the spine and brain revealed dural masses at the lumbosacral junction with invasion to the L5 and S1 ...
Source: World Journal of Gastroenterology : WJG - Category: Gastroenterology Authors: Tags: World J Gastroenterol Source Type: research
In conclusion, physicians must be vigilant when patients with breast cancer history present with gastrointestinal symptoms, despite gastric metastasis from breast cancer being rare. An appropriate systemic therapeutic strategy that includes hormonal therapy may be beneficial for this group of patients. PMID: 28943914 [PubMed]
Source: Oncology Letters - Category: Cancer & Oncology Tags: Oncol Lett Source Type: research
Conclusions Implementing a PIPAC program in association with systemic chemotherapy is feasible and is associated with a risk of postoperative morbidity, even in teams highly experienced in PC management and requires a learning curve in patient selection. Teaser PIPAC is a recent approach for intraperitoneal chemotherapy with promising results for patients with PC. Implementing a PIPAC program in association with systemic chemotherapy is associated with a risk of postoperative morbidity, even in teams highly experienced in PC management.
Source: European Journal of Surgical Oncology (EJSO) - Category: Surgery Source Type: research
Abstract PURPOSE: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) benefit patients with peritoneal carcinomatosis. Nevertheless, this therapy is associated with considerable postoperative pain due to the extensive abdominal incision. While epidural analgesia offers efficacious pain control, CRS and HIPEC therapy is associated with perioperative coagulopathy that may impact its use. The purpose of this retrospective study is to characterize the postoperative coagulopathy in this patient subset and to develop a model that will help predict those at risk. METHODS: Our database o...
Source: Canadian Journal of Anaesthesia - Category: Anesthesiology Authors: Tags: Can J Anaesth Source Type: research
We report the first case of mixed adenocarcinoma and SCC occurring i n the third part of duodenum (D3). Our patient, a 64-year-old female with history of GERD, hypertension, and IDDM presented with 4 weeks of nausea, vomiting, and abdominal pain. Tomographic imaging of her abdomen demonstrated a distended stomach and a proximal duodenum with narrow caliber changes at the level of D3. An EGD revealed a tight stricture at D3 that could not be traversed. Stricture biopsies revealed duodenal mucosa with two small foci of SCC (positive for p63 and CK5/6) and adenocarcinoma (positive for CK7 and Moc31). Peritoneal metastases wer...
Source: Case Reports in Gastroenterology - Category: Gastroenterology Source Type: research
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