Infectious complications after cytoreductive surgery and hyperthermic intra-peritoneal chemotherapy

Arslan N. Ç., SÖKMEN S., AVKAN OĞUZ V., Obuz F., Canda A. E., Terzi C., ...More

Surgical Infections, vol.18, no.2, pp.157-163, 2017 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 18 Issue: 2
  • Publication Date: 2017
  • Doi Number: 10.1089/sur.2016.102
  • Journal Name: Surgical Infections
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.157-163
  • Keywords: hyperthermic intra-peritoneal chemotherapy, infection, morbidity, oncology, peritoneal carcinomatosis
  • Istanbul Medipol University Affiliated: No


Background: The aim of this study was to review the post-operative and infectious complications and determine the risk factors associated with infections in cytoreductive surgery (CRS) and hyperthermic intra-peritoneal chemotherapy (HIPEC). Patients and Methods: Between October 2007 and December 2013, patients who underwent CRS and HIPEC with a curative intent were included in the study. The Centers for Disease Control and Prevention's National Nosocomial Infections Surveillance System definitions were used to identify post-operative nosocomial infections. Results: One hundred and sixty-nine CRS and HIPEC procedures were performed. Overall, 155 complications were observed in 82 (48.5%) patients. Grade 3-4 morbidity rate was 25.5% (n = 43). Seventy infections occurred in 47 patients. Surgical site infection was the most common infectious complication. The most common micro-organism isolated from the cultures was Escherichia coli. Age (odds ratio [OR]1.039, confidence interval [CI] 1.006-1.073), the mean total number of staff scrubbing in the operation(OR 2.241, CI 1.415-3.548), and intensive care unit stay (OR 1.325, CI 0.953-1.842) were independent risk factors for infectious complications. Conclusions: Infectious complications are the most important cause of peri-operative morbidity and death in CRS and HIPEC. As well as patient and tumor characteristics, surgeon/center-related factors play an important role in infectious morbidity. Patients with peritoneal carcinomatosis should be considered as a complex oncologic group at high risk of infectious complications.