scholarly journals Postoperative C-reactive protein kinetics predict postoperative complications in patients treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis

2020 ◽  
Author(s):  
Antoine El Asmar ◽  
Melissa Bendavides ◽  
Michel Moreau ◽  
Alain Hendlisz ◽  
Amélie Deleporte ◽  
...  
Keyword(s):  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
White Blood Cells ◽  
High Morbidity ◽  
C Reactive Protein ◽  
Platelet Counts ◽  
Reactive Protein ◽  
Operative Complications ◽  
Post Operative Complications

Abstract Background Relatively high morbidity rates are reported after cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC). However, early predictors of complications after CRS plus HIPEC have not been identified. The aim of this study was to evaluate the predictive role of early postoperative serum C-reactive protein (CRP) level (Day 2-4) for the detection of post-operative complications. Patients and methods We performed a retrospective study including 94 patients treated with complete CRS (R1) and HIPEC for PC from various primary origins (2011-2016). Post-operative complications were recorded. The values for postoperative inflammatory markers (white blood cells [WBC] and platelet counts, CRP) were compared between the different groups. Results CRP on post-operative days 2-4 was significantly higher in patients with than without complications (124 mg/L vs 46 mg/L; p<0.0001) and higher in those with more major complications (162 mg/L vs 80 mg/L; p< 0.0012). WBC and platelet counts showed no difference within 5 days postoperatively. Conclusion CRP levels, and kinetics mainly, between post-operative day 2 and 4, are decisive predictive markers of early and late post-operative complications after CRS plus HIPEC. The presence of post-operative complications should be suspected in patients with a high CRP mean, and a plateau level (days 2-4).

scholarly journals Postoperative C-reactive protein kinetics predict postoperative complications in patients treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Antoine El Asmar ◽  
Melissa Bendavides ◽  
Michel Moreau ◽  
Alain Hendlisz ◽  
Amélie Deleporte ◽  
...  
Keyword(s):  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
White Blood Cells ◽  
High Morbidity ◽  
C Reactive Protein ◽  
Platelet Counts ◽  
Reactive Protein ◽  
Operative Complications ◽  
Post Operative Complications

Abstract Background Relatively high morbidity rates are reported after cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC). However, early predictors of complications after CRS plus HIPEC have not been identified. The aim of this study was to evaluate the predictive role of early postoperative serum C-reactive protein (CRP) level (Day 2–4) for the detection of post-operative complications. Patients and methods We performed a retrospective study including 94 patients treated with complete CRS (R1) and HIPEC for PC from various primary origins (2011–2016). Post-operative complications were recorded. The values for postoperative inflammatory markers (white blood cells [WBC] and platelet counts, CRP) were compared between the different groups. Results CRP on post-operative days 2–4 was significantly higher in patients with than without complications (124 mg/L vs 46 mg/L; p < 0.0001) and higher in those with more major complications (162 mg/L vs 80 mg/L; p < 0.0012). WBC and platelet counts showed no difference within 5 days postoperatively. Conclusion CRP levels, and kinetics mainly, between post-operative day 2 and 4, are decisive predictive markers of early and late post-operative complications after CRS plus HIPEC. The presence of post-operative complications should be suspected in patients with a high CRP mean, and a plateau level (days 2–4).

scholarly journals Postoperative C-reactive protein kinetics predict postoperative complications in patients treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis

2020 ◽  
Author(s):  
Antoine El Asmar ◽  
Melissa Bendavides ◽  
Michel Moreau ◽  
Alain Hendlisz ◽  
Amélie Deleporte ◽  
...  
Keyword(s):  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
White Blood Cells ◽  
High Morbidity ◽  
C Reactive Protein ◽  
Platelet Counts ◽  
Reactive Protein ◽  
Operative Complications ◽  
Post Operative Complications

Abstract Background: Relatively high morbidity rates are reported after cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC). However, early predictors of complications after CRS plus HIPEC have not been identified. The aim of this study was to evaluate the predictive role of early postoperative serum C-reactive protein (CRP) level (Day 2-4) for the detection of post-operative complications.Patients and methods: We performed a retrospective study including 94 patients treated with complete CRS (R1) and HIPEC for PC from various primary origins (2011-2016). Post-operative complications were recorded. The values for postoperative inflammatory markers (white blood cells [WBC] and platelet counts, CRP) were compared between the different groups.Results: CRP on post-operative days 2-4 was significantly higher in patients with than without complications (124 mg/L vs 46 mg/L; p<0.0001) and higher in those with more major complications (162 mg/L vs 80 mg/L; p< 0.0012). WBC and platelet counts showed no difference within 5 days postoperatively.Conclusion: CRP levels, and kinetics mainly, between post-operative day 2 and 4, are decisive predictive markers of early and late post-operative complications after CRS plus HIPEC. The presence of post-operative complications should be suspected in patients with a high CRP mean, and a plateau level (days 2-4).

scholarly journals Predictive Ability of C-Reactive Protein in Detecting Short-Term Complications After Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: A Retrospective Cross-Sectional Study

2020 ◽  
Vol 28 (1) ◽  
pp. 233-243
Author(s):  
Job P. van Kooten ◽  
Arvind Oemrawsingh ◽  
Nadine L. de Boer ◽  
Cornelis Verhoef ◽  
Jacobus W. A. Burger ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Characteristic Curve ◽  
Predictive Ability ◽  
Cross Sectional Study ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Reactive Protein

Abstract Background Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is a potentially curative treatment for peritoneal carcinomatosis. Objective The aim of this study was to determine the predictive value of postoperative inflammatory biomarkers in assessing complications after CRS and HIPEC. Methods A prospective database of 181 patients, who underwent CRS-HIPEC between March 2014 through April 2018 in the Erasmus MC, was retrospectively analyzed. Postoperative complications were defined according to the serious adverse event (SAE) grading system. Levels of C-reactive protein (CRP) and white blood cell (WBC) count were compared between patients with SAE grade < 3 and SAE grade ≥ 3. The area under the receiver operating characteristic curve (AUC) was calculated for CRP and WBC against SAE ≥ 3 and various intra-abdominal complications. Results SAE ≥ 3 postoperative complications occurred in 50 patients. From the second until the fifth postoperative day (POD), CRP levels were significantly higher (p = 0.023, p < 0.001, p = 0.002, and p = 0.002, respectively) in these patients. CRP concentrations above 166 mg/L on POD3 (AUC 0.75) and 116 mg/L on POD4 (AUC 0.70) were associated with the highest risk of an SAE ≥ 3. Postoperative WBC levels were not significantly different between patients with SAE < 3 and SAE ≥ 3 complications. Conclusion Data from our hospital suggest that CRP levels that continue to rise after POD2 or that are ≥ 166 mg/L at POD3 or ≥ 116 mg/L at POD4, indicate a considerable risk for developing high-grade SAEs. The cut-off values we found can potentially be used as a threshold for additional diagnostic interventions, after they have been validated in external data.

scholarly journals The Impact of Multidisciplinary Team Approach on Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis

2021 ◽  
Vol 11 (12) ◽  
pp. 1313
Author(s):  
Hao-Chien Hung ◽  
Po-Jung Hsu ◽  
Ting-Chang Chang ◽  
Hung-Hsueh Chou ◽  
Kuan-Gen Huang ◽  
...  
Keyword(s):  
Peritoneal Carcinomatosis ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
P Value ◽  
Team Approach ◽  
Complication Rates ◽  
Operative Complication ◽  
Operative Complications ◽  
Post Operative Complications

Background: Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS–HIPEC) is a therapeutic approach used to achieve curative treatment in intra-abdominal malignancy with peritoneal carcinomatosis (PC). However, it is a complicated procedure with high post-operative complication rates. Thus, we analyzed our preliminary data to establish whether multidisciplinary teamwork (MDT) implementation is beneficial for CRS–HIPEC outcomes. Method: A series of 132 consecutive patients with synchronous or recurrent PC secondary to gastrointestinal or gynecologic cancer who received CRS–HIPEC operation between May 2015 and September 2017 were included. Ninety-nine patients were categorized into the MDT group, with the 33 other patients into the non-MDT group. Results: The mean PCI score was 16.3 ± 8.8. Patients in the MDT group more often presented a higher PCI score (p value = 0.038). Regarding CRS completeness (CCR 0–1), it was distributed 81.8% and 57.6% in the MDT and the non-MDT group, respectively (p value = 0.005). Although post-operative complications were common (n = 62, 47.0%), post-operative complication rates did not differ between the two groups. The cumulative OS survival rate at the first year was 75.5%. Older age (p = 0.030, HR = 4.58, 95% CI = 1.16–18.10), ECOG 2 (p = 0.030, HR = 6.41, 95% CI = 1.20–34.14), and incomplete cytoreduction (p = 0.048, HR = 2.79, 95% CI = 1.04–8.27) were independent prognostic factors for survival. Conclusions: Our experience suggests that the CRS–HIPEC performed under MDT cooperation may result in higher complete cytoreduction rates without increasing post-operative complications and hospital mortalities.

C-Reactive protein as a predictor of post-operative complications in bariatric surgery patients

2018 ◽  
Vol 33 (8) ◽  
pp. 2479-2484 ◽  
Author(s):  
Marie Ashley Villard ◽  
Melissa C. Helm ◽  
Tammy L. Kindel ◽  
Matthew I. Goldblatt ◽  
Jon C. Gould ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Operative Complications ◽  
Post Operative Complications

scholarly journals Morbidity and Mortality Outcomes of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy at a Single Institution in Japan

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Akiyoshi Mizumoto ◽  
Emel Canbay ◽  
Masamitsu Hirano ◽  
Nobuyuki Takao ◽  
Takayuki Matsuda ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Peritoneal Carcinomatosis ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Mortality Rates ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Single Institution ◽  
Crs And Hipec

Background. Even though cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are associated with a high morbidity and mortality rates, it has been reported that CRS and HIPEC improved survival of selected patients with peritoneal carcinomatosis. We aimed to report morbidity and mortality results of CRS and HIPEC from a single institution in Japan.Methods and Results. Total of 284 procedures of CRS were performed on patients with pseudomyxoma peritonei, peritoneal carcinomatosis (PC) from colon cancer and gastric cancer between 2007 and 2011 in our institution. The morbidity rate was 49% of all procedure, and grades I/II and grades III/IV complications were 28% and 17%, respectively. Most frequent complication was surgical site infections including intraabdominal abscess. The mortality rate was 3.5%, and reoperation was needed in 11% of all procedures. Univariate and multivariate analysis showed peritoneal carcinomatosis index (PCI) greater than 20 was the only significant factor for occurrence of postoperative complications (P<0.01). In contrast, HIPEC significantly reduced postoperative complications (P<0.05).Conclusions. The morbidity and mortality rates of our institution are comparable with previous reports that are in acceptable rates. Optimal patient selection such as patients with PCI less than 20 seems to be of paramount importance to CRS and HIPEC.

scholarly journals Serum C-reactive protein and Pro-Calcitonin as an Indicator in Post-Operative Infection after Hepatobiliary Surgery

2020 ◽  
Vol 3 (1) ◽  
pp. 64-70
Author(s):  
Joshua CC ◽  
Sreejith V ◽  
A. Sreekumar
Keyword(s):  
Serum Albumin ◽  
P Value ◽  
Specific Marker ◽  
Hepatobiliary Surgery ◽  
C Reactive Protein ◽  
Biliary Surgery ◽  
Reactive Protein ◽  
Operative Complications ◽  
Serum Crp ◽  
Post Operative Complications

Background: Major hepato-biliary surgeries carry a high risk for post-operative sepsis. Recent therapeutic advances both medical and surgical have improved early post-operative outcome. Considering the difficulties in diagnosis of infection in critically ill patients an early sensitive  and specific marker for sepsis would be of interest. Studies have shown that C - reactive protein (CRP) and pro calcitonin (PCT) are acute phase reactants and good independent early markers of post-operative sepsis, severe or septic shock. This aspect has not been evaluated in     the hepatobiliary surgeries. More over there is no data available from the Indian sub-continent in this aspect. This study aims to evaluate the efficacy of serum CRP and PCT levels after hepatobiliary surgery for diagnosis of postoperative complication. Subjects and Methods: This is a cross-sectional diagnostic study has conducted in 42 patients who all are satisfying the inclusion criteria. Study duration was From August 2017 to July 2019, conducted on patients between 18-80yrs of age undergoing hepato-biliary surgery, in surgical wards of PK Das Institute     of Medical Sciences. Study variables include age, sex, pre-operative serum albumin level, pre and post-operative S.CRP AND S.PCT levels. On post-operative day 4 and day 7 S.CRP and S.PCT are monitored and its predictability also measured. . Descriptive statistical analysis will be carried out using SPSS (IBM). The p-value of less than 0.05 will be taken as significant. Results: out of 42 patients studied, 30 patients developed post-operative complications. Pre-operative serum C - reactive protein and serum procalcitonin measured compared with pre-operative serum albumin was significant identifying post-operative complications (P-value 0.02). On post-operative day 4 and 7value was significant in post-operative patients with P-value of 0.04 vs. 0.046 respectively. Similarly serum procalcitonin values also were significant on postoperative day (POD) 4 and 7 with P-value of 0.02 and 0.03. Sensitivity and specificity of S.PCT was more compared to S.CRP (92 vs 90% in sensitivity and 100% vs 80% in specificity respectively. This study shows those who were clinically septic post operatively have statistically elevated levels of serum CRP and Procalcitonin. Conclusion: S.PCT is more sensitive and specific as a marker of post operative infection following hepato biliary surgery. Early identification of patients with insidious septic illness allows early therapeutic intervention which may favorably influence outcome.

scholarly journals Effect of Preoperative Immunonutrition on Postoperative Major Morbidity after Cytoreductive Surgery and HIPEC in Patients with Peritoneal Metastasis

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2147
Author(s):  
Alba Fernández-Candela ◽  
Alicia Calero ◽  
Luís Sánchez-Guillén ◽  
Javier Escrig-Sos ◽  
José A. Barreras ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Peritoneal Carcinomatosis ◽  
Cytoreductive Surgery ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
C Reactive Protein ◽  
Predictive Values ◽  
Major Morbidity ◽  
Factors Associated ◽  
Reactive Protein ◽  
Rule Out

The effect of preoperative immunonutrition intake on postoperative major complications in patients following cytoreductive surgery (CRS) with or without hyperthermic intraperitoneal chemotherapy (HIPEC) was assessed. The accuracy of C-Reactive Protein (CRP) for detecting postoperative complications was also analyzed. Patients treated within a peritoneal carcinomatosis program in which a complete or optimal cytoreduction was achieved were retrospectively analyzed. They were divided into two groups based on whether preoperative immunonutrition (IMN) or not (non-IMN) were administered. Clinical and surgical variables and postoperative complications were gathered. Predictive values of major morbidity of CRP during the first 3 postoperative days (POD) were also evaluated. A total of 107 patients were included, 48 belonging to the IMN group and 59 to the non-IMN group. In multivariate analysis immunonutrition (OR 0.247; 95%CI 0.071–0.859; p = 0.028), and the number of visceral resections (OR 1.947; 95%CI 1.086–3.488; p = 0.025) emerged as independent factors associated with postoperative major morbidity. CRP values above 103 mg/L yielded a negative predictive value of 84%. Preoperative intake of immunonutrition was associated with a decrease of postoperative major morbidity and might be recommended to patients with peritoneal carcinomatosis following CRS. Measuring CRP levels during the 3 first postoperative days is useful to rule out major morbidity.

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