Abstract
BackgroundTo analyse the duration of parenteral nutrition (PN) in patients treated for peritoneal malignancy with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) over a 2 year period at a single UK National referral centre.MethodsA retrospective analysis of prospective data for all patients (n=321) who underwent CRS and HIPEC for peritoneal malignancy at the Peritoneal Malignancy Institute Basingstoke between April 1, 2013 and March 31, 2015.Duration of PN was compared between primary tumour site (appendix, colorectal, mesothelioma and other); completeness of CRS (complete CRS vs. major tumour debulking) and pre-operative nutritional assessment measures (including Mid Upper Arm Circumference).ResultsThe median duration of PN was 9 days (range 2–87 days). A total of 13 % of patients had PN for less than 7 days and 6 % for 5 days or less. There was no significant difference in duration of PN between the different tumour sites. Two factors that may increase the duration of PN include having major tumour debulking (MTD) and a baseline MUAC<23.5 cm.ConclusionsMost patients who underwent CRS and HIPEC for peritoneal malignancy required PN for more than 7 days with poor pre-operative nutritional status and inability to achieve complete cytoreduction predictors of prolonged PN requirements.
Highlights
Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) was initially developed and popularized for Pseudomyxoma peritonei (PMP) of appendiceal origin [1,2,3] or primary peritoneal tumours with favourable biological behaviour, such as multicystic peritoneal mesothelioma [4, 5]
The Peritoneal Malignancy Institute Basingstoke, part of Hampshire Hospitals Foundation Trust was commissioned as a national centre for the assessment and surgical management of PMP in 2000
We retrospectively reviewed prospectively collected nutrition and surgical data for all patients who had cytoreductive surgery (CRS) and HIPEC for the treatment of peritoneal malignancy at the Peritoneal Malignancy Institute over a 2 year period (April 1, 2013 to March 31, 2015)
Summary
Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) was initially developed and popularized for Pseudomyxoma peritonei (PMP) of appendiceal origin [1,2,3] or primary peritoneal tumours with favourable biological behaviour, such as multicystic peritoneal mesothelioma [4, 5]. If the tumour cannot be completely removed (generally because of extensive small bowel involvement or suboptimal patient performance status) MTD is performed [9]. This procedure involves removal of as much tumour as possible which generally includes the right colon with an ileocolic anastomosis or a total colectomy with an end ileostomy, an omentectomy and in females bilateral salpingo-oophorectomy. To analyse the duration of parenteral nutrition (PN) in patients treated for peritoneal malignancy with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) over a 2 year period at a single UK National referral centre. Conclusions: Most patients who underwent CRS and HIPEC for peritoneal malignancy required PN for more than 7 days with poor pre-operative nutritional status and inability to achieve complete cytoreduction predictors of prolonged PN requirements
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