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Surgical results of patients with peritoneal carcinomatosis treated with cytoreductive surgery using a new technique named aqua dissection.

Yonemura Y, Elnemr A, Endou Y, Ishibashi H, Mizumoto A, Miura M, Li Y - Gastroenterol Res Pract (2012)

Bottom Line: Complete cytoreduction was done in 62/81 (76.5%), 228/420 (54.3%), and 101/166 (60.8%) of patients with CRC, APN, and GC.Conclusions.Patients with PCI larger than the threshold values should be treated with chemotherapy to improve the incidences of complete cytoreduction.

View Article: PubMed Central - PubMed

Affiliation: NPO Organization to Support Peritoneal Surface Malignancy Treatment, 1-26, Haruki-Moto-Machi, Kishiwada, Osaka, Japan.

ABSTRACT
During 2004 to 2011, 81, 420, and 166 patients with colorectal cancer (CRC), epithelial appendiceal neoplasm (APN), and gastric cancer (GC) with PC were treated with cytoreductive surgery (CRS) plus perioperative chemotherapy. CRS was performed by peritonectomy techniques using an aqua dissection. Results. Complete cytoreduction was done in 62/81 (76.5%), 228/420 (54.3%), and 101/166 (60.8%) of patients with CRC, APN, and GC. The main reasons of incomplete resections were involvement of all peritoneal regions and diffuse involvement of small bowel. The incidence (64%, 302/470) of CC-0 resection after introduction of an aqua dissection was significantly higher than before (42%, 82/197). A total of 41 (6.1%) patients died postoperatively. Major complication (grade 3-4 complications) occurred in 126 patients (18.9%). A reoperation was necessary in 36 patients (5.4%). By the multivariate analysis, PCI scores capable of serving as thresholds for favorable versus poor prognosis in each group and CC scores demonstrated as the independent prognostic factors. Conclusions. Peritonectomy using an aqua dissection improves the incidence of complete cytoreduction, and improves the survival of patients with PC. Patients with PCI larger than the threshold values should be treated with chemotherapy to improve the incidences of complete cytoreduction.

No MeSH data available.


Related in: MedlinePlus

Dissection of the tumor in the superior omental recessus. By traction of tumors to the left side, the capsule of the caudate lobe is cut and the tumors with liver capsule and retroperitoneum are dissected from the caudate lobe, left crural muscle, and vena cave.
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fig11: Dissection of the tumor in the superior omental recessus. By traction of tumors to the left side, the capsule of the caudate lobe is cut and the tumors with liver capsule and retroperitoneum are dissected from the caudate lobe, left crural muscle, and vena cave.

Mentions: Morrison's pouch and the paracolic gutter are the common sites of tumor implantation. The peritoneum covering Morrison's pouch is removed with the peritoneum on the right paracolic gutter, right subdiaphragm, and right abdominal wall (Figures 11 and 12).


Surgical results of patients with peritoneal carcinomatosis treated with cytoreductive surgery using a new technique named aqua dissection.

Yonemura Y, Elnemr A, Endou Y, Ishibashi H, Mizumoto A, Miura M, Li Y - Gastroenterol Res Pract (2012)

Dissection of the tumor in the superior omental recessus. By traction of tumors to the left side, the capsule of the caudate lobe is cut and the tumors with liver capsule and retroperitoneum are dissected from the caudate lobe, left crural muscle, and vena cave.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3362043&req=5

fig11: Dissection of the tumor in the superior omental recessus. By traction of tumors to the left side, the capsule of the caudate lobe is cut and the tumors with liver capsule and retroperitoneum are dissected from the caudate lobe, left crural muscle, and vena cave.
Mentions: Morrison's pouch and the paracolic gutter are the common sites of tumor implantation. The peritoneum covering Morrison's pouch is removed with the peritoneum on the right paracolic gutter, right subdiaphragm, and right abdominal wall (Figures 11 and 12).

Bottom Line: Complete cytoreduction was done in 62/81 (76.5%), 228/420 (54.3%), and 101/166 (60.8%) of patients with CRC, APN, and GC.Conclusions.Patients with PCI larger than the threshold values should be treated with chemotherapy to improve the incidences of complete cytoreduction.

View Article: PubMed Central - PubMed

Affiliation: NPO Organization to Support Peritoneal Surface Malignancy Treatment, 1-26, Haruki-Moto-Machi, Kishiwada, Osaka, Japan.

ABSTRACT
During 2004 to 2011, 81, 420, and 166 patients with colorectal cancer (CRC), epithelial appendiceal neoplasm (APN), and gastric cancer (GC) with PC were treated with cytoreductive surgery (CRS) plus perioperative chemotherapy. CRS was performed by peritonectomy techniques using an aqua dissection. Results. Complete cytoreduction was done in 62/81 (76.5%), 228/420 (54.3%), and 101/166 (60.8%) of patients with CRC, APN, and GC. The main reasons of incomplete resections were involvement of all peritoneal regions and diffuse involvement of small bowel. The incidence (64%, 302/470) of CC-0 resection after introduction of an aqua dissection was significantly higher than before (42%, 82/197). A total of 41 (6.1%) patients died postoperatively. Major complication (grade 3-4 complications) occurred in 126 patients (18.9%). A reoperation was necessary in 36 patients (5.4%). By the multivariate analysis, PCI scores capable of serving as thresholds for favorable versus poor prognosis in each group and CC scores demonstrated as the independent prognostic factors. Conclusions. Peritonectomy using an aqua dissection improves the incidence of complete cytoreduction, and improves the survival of patients with PC. Patients with PCI larger than the threshold values should be treated with chemotherapy to improve the incidences of complete cytoreduction.

No MeSH data available.


Related in: MedlinePlus