Thesis (Ph.D.) - Cairo University - National Cancer Institute - Department of Oncology (Surgical)

Aim of work. The purpose of our study was to evaluate the perioperative complications, toxicity, mortality rates after cytoreductive surgery (CRS), and effects of hyperthermic intraperitoneal chemotherapy (HIPEC) used in the treatment of peritoneal surface malignancies. At a single institution" National Cancer Institution" in Egypt. Results. Total of 51 procedures of CRS and HIPEC were performed on patients with, peritoneal carcinomatosis (PC) from different primary cancer. The morbidity rate was 39.2% of all procedure, and grades I/II and grades III/IV complications were 19.6 % and 19.6 %, respectively according Common Terminology Criteria for Adverse Events (CTCAE). The most frequent complication was intestinal leakage including intestinal fistula 35% (7/20) of total number of postoperative complications. The mortality rate was 5.8%, and reoperation was needed in 3.9 % of all procedures (2/51).Mortalities were in cases of anastomotic leakage were required reoperation , first patient, to do ileostomy and burst abdomen for closure and the second one to do closure of abdomen to repair burst abdomen and debridement of wound sepsis. Multivariate analysis showed Operative time was the most significant factor which increased the occurrence of postoperative complications. Operative time shows direct relationship with morbidity, the longer the operative time, the more risk having morbid condition (P < 0.004). (One hour increase in operative length =increase 1.5 liability to have morbid condition. No signi{uFB01}cant difference was observed among age, gender, PCI and origin of the primary tumor, and occurrence of toxicity and surgical complications. Prolonged operation times resulted in higher complication and/or toxicity rates (P < 0.004).

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