Extending the Indications of Intestinal Transplantation - modified multivisceral transplantation for end-stage pseudomyxoma peritoneii

Reddy, Srikanth; Cecil, Tom; Allan, Phil; Vrakas, Georgios; Smith, Ali; Holdaway, L; Vokes, Lisa; Mohamad, Faheez; Moran, Brendan; Peter, F Sharkey

doi:10.1097/01.tp.0000521415.60497.9b

Cited by 10 publications

(5 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…An interesting development over the past decade in the management of recurrent pseudomyxoma peritonei (PMP) is modified multivisceral transplantation. Reddy and colleagues asserted that recurrent PMP inevitably progresses to nutritional failure as a result of small bowel obstruction and fistulation, and proposed that, for patients with end‐stage PMP, CRS followed by modified multivisceral transplantation could prolong life. They reported on six patients who had this treatment between 2013 and 2016; four survived at review of 2, 4, 18 and 22 months after surgery, and two had died (on days 26 and 64).…”

Section: Discussionmentioning

confidence: 99%

Repeat cytoreductive surgery with or without intraperitoneal chemotherapy for recurrent epithelial appendiceal neoplasms

et al. 2020

View full text Add to dashboard Cite

Background: With recurrence rates after primary cytoreductive surgery (CRS) in excess of 50 per cent, repeat CRS is being performed increasingly, but survival outcomes have not been reported widely. This study examined the outcomes following repeat CRS for appendiceal cancer with peritoneal surface malignancy (PSM), and evaluated its feasibility and safety.Methods: A retrospective cohort of patients who had surgery between 1996 and 2018 were analysed. Patients who underwent a single CRS procedure with or without heated intraperitoneal chemotherapy (HIPEC) were compared with those who had multiple procedures with or without HIPEC. Perioperative morbidity and survival outcomes were analysed.Results: Some 462 patients were reviewed, 102 of whom had repeat procedures. For high-grade tumours, patients who had a single CRS procedure had significantly reduced overall survival (OS) compared with those who had repeat CRS (55⋅6 versus 90⋅7 months respectively; P = 0⋅016). For low-grade tumours, there was no difference in OS (P = 0⋅153). When patients who had a single procedure were compared with those who had multiple procedures, there was no significant difference in major morbidity (P = 0⋅441) or in-hospital mortality (P = 0⋅080). For multiple procedures, no differences were found in major morbidity (P = 0⋅262) or in-hospital mortality (P = 0⋅502) when the first procedure was compared with the second. For low-grade cancers, the peritoneal carcinomatosis index was a significant prognostic factor for OS (hazard ratio (HR) 1⋅11, 95 per cent c.i. 1⋅05 to 1⋅17; P < 0⋅001), whereas for high-grade cancers repeat CRS (HR 0⋅57, 0⋅33 to 0⋅95; P = 0⋅033), complete cytoreduction score (HR 1⋅55, 1⋅01 to 2⋅40; P = 0⋅046) and presence of signet ring cells (HR 2⋅77, 1⋅78 to 4⋅30; P < 0⋅001) were all significant indicators of long-term survival. Conclusion:In selected patients presenting with PSM from epithelial appendiceal neoplasms, repeat CRS performed in high-volume centres could provide survival benefits.

show abstract

Section: Discussionmentioning

confidence: 99%

Repeat cytoreductive surgery with or without intraperitoneal chemotherapy for recurrent epithelial appendiceal neoplasms

et al. 2020

View full text Add to dashboard Cite

show abstract

“…However, opportunity for these transplants in Australia remains limited, and data surrounding intestine transplant lags behind other transplants [ 5 ]. Early studies have shown that multi-visceral transplantation including small bowel is feasible in appendiceal adenomucinosis patients, and provides notable improvements in survival and quality of life [ 6 , 7 ]. These findings are consistent with broader studies supporting small bowel transplant as a means to wean patients off TPN and tube feeding, and thus potentially avoid the complications presented in this case [ 8 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

Case report: Total enterectomy following complete small bowel ischaemia in the post-peritonectomy setting

Coulshed

Soucisse

Lansom

et al. 2020

International Journal of Surgery Case Reports

View full text Add to dashboard Cite

show abstract

“…HPN can provide long-term nutritional support for a median of 338 days (71–2198) in patients with low- and high-grade PMP [ 34 ], but it is not able to palliate obstruction symptoms and abdominal wall entero-cutaneous fistulas. In these cases, salvage cytoreductive surgery followed by small bowel/multivisceral transplant (SBMT) has been tested [ 35 , 36 ]. In a recent review, out of the eight patients treated with SBMT, three died in the post-operative period for intestinal fistula and graft versus host disease (GVHD), without rejection of the intestine.…”

Section: New Surgical Approachesmentioning

confidence: 99%

Novel Perspectives in Pseudomyxoma Peritonei Treatment

Sommariva

Tonello

Rigotto

et al. 2021

Cancers

View full text Add to dashboard Cite

Pseudomyxoma Peritonei (PMP) is an anatomo-clinical condition characterized by the implantation of neoplastic cells on peritoneal surfaces with the production of a large amount of mucin. The rarity of the disease precludes the evaluation of treatment strategies within randomized controlled trials. Cytoreductive Surgery (CRS) combined with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) has proven to be the only therapeutic option with potential chances of cure and long-term disease control. The present review discusses the epidemiology, pathogenesis, clinical presentation and treatment of PMP, focusing on the molecular factors involved in tumor progression and mucin production that could be used, in the upcoming future, to improve patient selection for surgery and to expand the therapeutic armamentarium.

show abstract

Extending the Indications of Intestinal Transplantation - modified multivisceral transplantation for end-stage pseudomyxoma peritoneii

Cited by 10 publications

References 0 publications

Repeat cytoreductive surgery with or without intraperitoneal chemotherapy for recurrent epithelial appendiceal neoplasms

Repeat cytoreductive surgery with or without intraperitoneal chemotherapy for recurrent epithelial appendiceal neoplasms

Case report: Total enterectomy following complete small bowel ischaemia in the post-peritonectomy setting

Novel Perspectives in Pseudomyxoma Peritonei Treatment

Contact Info

Product

Resources

About