Methods to increase the effectiveness of cytoreductive surgical interventions in patients with complicated disseminated tumors of the abdominal cavity and pelvis
- Authors: Nguyen V.1, Prosvetov V.A.1, Bromberg B.B.1, Dymnikov D.A.1, Loginov V.A.1, Demko A.E.1,2, Solovеv I.A.1,3, Surov D.A.1,2
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Affiliations:
- Kirov Military Medical Academy
- Saint Petersburg Scientific Research Institute of Ambulance named after I.I. Janelidze
- Mariinskaya Hospital
- Issue: Vol 25, No 1 (2023)
- Pages: 23-32
- Section: Research paper
- URL: https://journals.rcsi.science/1682-7392/article/view/134083
- DOI: https://doi.org/10.17816/brmma120006
- ID: 134083
Cite item
Abstract
The expediency of performing two-stage cytoreductive interventions in patients with complicated disseminated tumors of the abdominal cavity and pelvis is presented. Ninety-two patients with complicated disseminated tumors of the abdominal cavity and pelvis were examined into two groups. The main group consisted of 33 patients who received surgical treatment by two-stage cytoreductive surgery. The control group included 59 patients who underwent single-stage cytoreductive operations. In both groups, life-threatening complications were dominated by primary tumor necrosis (main group, n = 15; control group, n = 31) and impaired intestinal patency (main group, n = 12; control group, n = 16, respectively). The average Charlson comorbidity index was 7.85 ± 1.37 and 7.53 ± 1.5 points, respectively. Anesthetic risk of grades III–IV according to the classification of the American Society of Anesthesiologists was detected in 23 (69.7%) and 45 (76.27%) patients of the main and control groups, respectively. Functional status of 2–3 points on the Eastern Cooperative Oncological Group was established in 23 (69.7%) and 46 (77.9%) patients of the main and control groups, respectively. The peritoneal carcinomatosis index was significantly higher in the main group (13.1 ± 6 vs 9.9 ± 4.8 points) than in the control group (p = 0.012). A comparative analysis of the results obtained in the treatment of the main and control groups demonstrated that the two-stage cytoreductive surgical interventions can reduce the frequency of postoperative complications, primarily Clavien–Dindo grades III–IV from 40.7 to 18.2% (p = 0.049) and mortality from 16.9% to 9.1% (p = 0.468) and increase the frequency of achieving complete cytoreduction from 49.1% to 90.9% (p = 0.002) and the frequency of intraperitoneal hyperthermic chemoperfusion from 40.7 to 93.9% (p < 0.001). Thus, two-stage cytoreductive surgical interventions are a safe and effective technique in the surgical treatment of complicated disseminated tumors of the abdominal cavity and pelvis.
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##article.viewOnOriginalSite##About the authors
Van Thu Nguyen
Kirov Military Medical Academy
Author for correspondence.
Email: thuhvqy@gmail.com
ORCID iD: 0000-0002-5546-2371
SPIN-code: 6895-5893
adjunct
Viet Nam, Saint PetersburgVadim A. Prosvetov
Kirov Military Medical Academy
Email: thuhvqy@gmail.com
ORCID iD: 0000-0002-5503-1598
SPIN-code: 1717-7735
resident
Russian Federation, Saint PetersburgBoris B. Bromberg
Kirov Military Medical Academy
Email: thuhvqy@gmail.com
ORCID iD: 0000-0001-9940-7772
SPIN-code: 4567-6403
MD, Cand. Sci. (Med.)
Russian Federation, Saint PetersburgDenis A. Dymnikov
Kirov Military Medical Academy
Email: thuhvqy@gmail.com
ORCID iD: 0000-0003-1644-1014
SPIN-code: 6945-7148
MD, Cand. Sci. (Med.)
Russian Federation, Saint PetersburgVladimir A. Loginov
Kirov Military Medical Academy
Email: www.exclusive@mail.ru
ORCID iD: 0000-0002-2100-6087
SPIN-code: 8481-7599
MD, Cand. Sci. (Med.), associate professor
Russian Federation, Saint PetersburgAndrey E. Demko
Kirov Military Medical Academy; Saint Petersburg Scientific Research Institute of Ambulance named after I.I. Janelidze
Email: demko@emergency.spb.ru
ORCID iD: 0000-0002-5606-288X
SPIN-code: 3399-8762
MD, Dr. Sci. (Med.), professor
Russian Federation, Saint Petersburg; Saint PetersburgIvan A. Solovеv
Kirov Military Medical Academy; Mariinskaya Hospital
Email: ivsolov@yandex.ru
ORCID iD: 0000-0001-9646-9775
SPIN-code: 6703-4852
MD, Dr. Sci. (Med.), professor
Russian Federation, Saint Petersburg; Saint PetersburgDmitry A. Surov
Kirov Military Medical Academy; Saint Petersburg Scientific Research Institute of Ambulance named after I.I. Janelidze
Email: thuhvqy@gmail.com
ORCID iD: 0000-0002-4519-0018
SPIN-code: 5346-1613
MD, Dr. Sci. (Med.), associate professor
Russian Federation, Saint Petersburg; Saint PetersburgReferences
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