Diaphragmatic Peritoneal Stripping Versus Full-Thickness Resection in CRS/HIPEC: Is There a Difference?

Sullivan, Brianne; Bekhor, Eliahu Y.; Carpiniello, Matthew; Leigh, Natasha; Pletcher, Eric; Solomon, Daniel; Magge, Deepa; Sarpel, Umut; Labow, Daniel M.; Golas, Benjamin

doi:10.1245/s10434-019-07797-8

Cited by 12 publications

(3 citation statements)

References 27 publications

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“…One factor affecting respiratory complications is diaphragmatic manipulation. Sullivan et al 36 demonstrated diaphragmatic stripping/resection to be associated with higher rates of pulmonary distress and postoperative pleural effusion (22% vs. 6%, p < 0.001; and 42% vs. 10%, p = 0.001; respectively). Diaphragmatic resection rates did not differ between low and high PCI groups in this study, neither was there a difference with full thickness resection of diaphragm requiring repair ( n = 44).…”

Section: Discussionmentioning

confidence: 99%

Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy: Effects of postoperative fluids beyond the first 24 h

Berger,

Sullivan,

Bekhor

et al. 2023

Journal of Surgical Oncology

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Background and ObjectivesThere are no guidelines for intravenous fluid (IVF) administration after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC). This study assessed rates of post‐CRS/HIPEC morbidity according to perioperative IVF administration.MethodsAll patients undergoing CRS/HIPEC March 2007 to June 2018 were reviewed, recording clinicopathologic, operative, and postoperative variables. Patients were divided by peritoneal cancer index (PCI), comparing IVF volumes and types administered intraoperatively and during the first 72 h postoperatively. Optimal IVF rate cutoffs calculated using area under the receiver operating characteristic curves and Youden's index determined associations with complications.ResultsOverall, 185 patients underwent CRS/HIPEC, and 81 (51%) had low PCI (<10) and 77 (49%) had high PCI (≥10). In low‐PCI patients, high IVF rates on postoperative days (POD) #0−2 were associated with higher overall complications: POD#0 (46% vs. 89%, p = 0.001), POD#1 (40% vs. 86%, p < 0.05), and POD#2 (42% vs. 72%, p < 0.05). High IVF rates were associated with respiratory distress (7% vs. 26%, p = 0.02) on POD#0, ileus (14% vs. 47%, p = 0.007) and intensive care unit stay (11% vs. 33%, p = 0.022) on POD#1, and ICU stay (8% vs. 33%, p = 0.003) on POD#2.ConclusionsFor low PCI patients undergoing CRS/HIPEC, higher IVF rates were associated with postoperative complications. Post‐CRS/HIPEC, IVF rates should be limited to prevent morbidity.

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Section: Discussionmentioning

confidence: 99%

Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy: Effects of postoperative fluids beyond the first 24 h

Berger,

Sullivan,

Bekhor

et al. 2023

Journal of Surgical Oncology

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“…We read with great interest the article by Sullivan et al 1 on their results following different types of diaphragmatic surgery in cytoreductive surgery (CRS)/hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal carcinomatosis of various origin. We recently updated our experience, and the study will soon be published.…”

Section: Dear Editormentioning

confidence: 99%

Letter to Sullivan BJ et al. “Diaphragmatic Peritoneal Stripping Versus Full-Thickness Resection in CRS/HIPEC: Is There a Difference?”

Carboni

Valle

2019

Ann Surg Oncol

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“…Диафрагмальная перитонэктомия в силу высокой технической сложности, сопряженной со значительным рисками ятрогенных повреждений, является наиболее трудным этапом циторедуктивных вмешательств [5,6,7,8,9,10,11] индекс Пинье = Р -(М+ОГК), где Р -рост человека в см, М -масса тела в кг, ОГК -окружность грудной клетки в покое в см. Согласно вычислениям данного показателя у лиц с мезоморфной (нормостенической) формой телосложения его значения равны 10-30, с долихоморфной (астенической) формой -более 30, а у лиц с брахиморфной (гиперстенической) формой -менее 10.…”

Section: Introductionunclassified

Morphometric parameters of the thoracic diaphragm in diverse body constructions

Prosvetov

Гайворонский

Surov

2023

Žurnal anatomii i gistopatologii

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The study of morphometric parameters of the thoracic diaphragm in diverse body constructions is of applied relevance in thoracic and abdominal surgery. The aim of the study was to investigate regional morphometric parameters of the thoracic diaphragm in diverse body constructions. Material and methods. The study involved 40 specially embalmed corpses (with preserved tissue elasticity), aged 35-75 when dying. To assess the morphometric parameters of the diaphragm, there was tailor-made an organocomplex represented by the abdominal cavity covered by an intact diaphragm. Longitudinal, transverse dimensions, the area of the diaphragm and its parts were investigated. Results. The analysed morphometric features allowed specifying that in extreme body constructions, there were considerable statistically significant differences in the morphometric parameters of the diaphragm and its parts. It was established that the largest area of the diaphragm, central tendon, costal part and its pericardial surface were observed in people with a brachymorphic body construction; the highest statistical significance was observed between extreme body constructions. The ratio of the tendon part to the total area was also the largest in the brachymorphic form, and the smallest in the dolichomorphic form. There were specific morphometric parameters typical of all types of body constructions: the ratio of the muscular and tendon parts of the diaphragm, the depth of the pleural sinuses, and the areas of the weak points of the diaphragm. The largest linear dimensions of all parts of the diaphragm were recorded in individuals with a brachymorphic body construction. On the contrary, people with dolichomorphic body type had the lowest values. However, the diaphragm domes were the highest in individuals with a dolichomorphic form, and the shortest in those with a brachymorphic form. Conclusion. The study of the morphometric parameters of the thoracic diaphragm allowed recording the major linear dimensions and areas of definite parts specific for all body constructions. The results obtained can be introduced into clinical practice to plan surgical interventions on the upper floor of the peritoneal cavity, including diaphragmatic peritonectomy.

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Diaphragmatic Peritoneal Stripping Versus Full-Thickness Resection in CRS/HIPEC: Is There a Difference?

Cited by 12 publications

References 27 publications

Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy: Effects of postoperative fluids beyond the first 24 h

Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy: Effects of postoperative fluids beyond the first 24 h

Letter to Sullivan BJ et al. “Diaphragmatic Peritoneal Stripping Versus Full-Thickness Resection in CRS/HIPEC: Is There a Difference?”

Morphometric parameters of the thoracic diaphragm in diverse body constructions

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