The Atypical Presentation and Delayed Timing of Anastomotic Leak in Patients Who Undergo Cytoreducation and Hyperthermic Intraperitoneal Chemotherapy.
Publication Title
The Journal of surgical research
Document Type
Article
Publication Date
10-9-2025
Keywords
washington; swedish
Abstract
Introduction: Anastomotic leak (AL) can be a disproportionately devastating complication following cytoreductive surgery (CRS)/hyperthermic intraperitoneal chemotherapy (HIPEC) due to its effect on both perioperative and oncologic outcomes. Anecdotally, patients who underwent CRS/HIPEC present in an atypically fashion compared to those who undergo non-CRS/HIPEC gastrointestinal surgery, but this has never been rigorously studied.
Methods: The records for all consecutive patients who underwent CRS/HIPEC with curative intent from prospectively maintained databases at two high-volume centers were retrospectively reviewed. Those who experienced AL were identified and dichotomized into early (
Results: On median postoperative day (POD) 15, 6.1% of patients experienced AL . Demographics, disease histology, risk factors for AL, receipt of neoadjuvant therapy, and extent of surgery were well-balanced. A higher proportion of small bowel anastomoses leaked in
Conclusions: Patients who experience AL after CRS/HIPEC often present in an atypical manner compared to those who undergo non-CRS/HIPEC gastrointestinal surgery. These findings are important to any practitioner who encounters CRS/HIPEC patients given that early recognition of AL is crucial to mitigating subsequent sequelae that can negatively impact both short-term perioperative and long-term oncologic outcomes in this uniquely challenging population.
Area of Special Interest
Cancer
Area of Special Interest
Digestive Health
Specialty/Research Institute
Oncology
Specialty/Research Institute
Gastroenterology
Specialty/Research Institute
Surgery
DOI
10.1016/j.jss.2025.09.037
