In recent years, cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have been increasingly used for the treatment of peritoneal metastases. Imaging examination plays an important role in the process of CRS+HIPEC in treatment of peritoneal metastasis. This article briefly introduces the preoperative imaging evaluation, postoperative imaging evaluation, and current limitations of CRS+HIPEC in the treatment of peritoneal metastases.
ObjectiveTo understand the current situation and factors affecting tube blockage (non-mechanical) during hyperthermic intraperitoneal chemotherapy (HIPEC). MethodsAccording to the inclusion and exclusion criteria, the patients with malignant tumors who underwent HIPEC in the Department of Gastroenterology of West China Hospital of Sichuan University from May 2019 to May 2021 were retrospectively gathered. The information about the patient and the occurrence of occlusion during HIPEC were obtained by consulting electronic medical records and perfusion records. The logistic regression analysis was performed to analyze the factors influencing non-mechanical tube blockage during HIPEC. ResultsA total of 240 patients with malignant tumors were gathered. During HIPEC, the non-mechanical tube blockage occurred in 88 patients with malignant tumors, with the incidence of 36.7%. The multivariate analysis results by logistic regression showed that the probabilities of non-mechanical tube blockage during HIPEC were higher in the patients with age≥65 years (OR=2.142, P=0.016), diabetes mellitus (OR=2.326, P=0.007), perfusion speed of 300–450 mL/min (OR=2.778, P=0.001), ascites (OR=2.192, P=0.020), and PCI ≥20 points (OR=4.380, P<0.001). ConclusionsPatients with malignant tumors treated with HIPEC are prone to non-mechanical tube blockage. The patients with middle-aged and elderly, diabetes, low perfusion speed, ascites, and high PCI score need to be of great concern, so as to prevent and deal with tube blockage in time.
ObjectiveTo explore the risk factors affecting on catheter obstruction during hyperthermic intraperitoneal chemotherapy (HIPEC). MethodsBased on the inclusion and exclusion criteria, the data of the patients who underwent HIPEC and related perfusion records at the First Affiliated Hospital of Xi’an Jiaotong University from February 2023 to December 2023 were retrospectively collected. The collected data were analyzed using Chi-square tests, machine learning, and non-parametric tests. The significance level was set at α=0.05. ResultsA total of 210 HIPEC patients meeting the criteria were included, of whom 51 (24.3%) experienced catheter obstruction. The univariate analysis revealed that the inflow-outflow temperature gradient of the perfusate (ΔT of the perfusate), perfusion flow rate, chemotherapy exposure, hypertension status, surgical approach, and HIPEC catheter length were associated with catheter obstruction (P<0.05). Subsequently, combining the results of the univariate analysis with feature values screened by machine learning, the following factors were selected, including HIPEC catheter length, ΔT of the perfusate, perfusion flow rate, age, gender, chemotherapy exposure, fibrinogen level, hypertension status, surgical approach, and blood transfusion. A predictive model for HIPEC catheter obstruction based on these features was established, achieving an area under the receiver operating characteristic curve (AUC) (95%CI) of 0.825 (0.757, 0.893). ConclusionThis study preliminarily identifies key factors influencing the incidence of catheter obstruction during HIPEC treatment, such as ΔT of the perfusate, perfusion flow rate, chemotherapy exposure, surgical approach, HIPEC catheter length, and hypertension, continuously monitoring these factors, thereby reducing the risk of catheter obstruction.