Mp48-12 Clinical Outcomes of Urological Reconstruction During Cytoreductive Surgery With Hyperthermic Intraperitoneal Chemotherapy

You have accessJournal of UrologyReconstruction: Ureteral Reconstruction (Including Pyeloplasty) and Bladder Reconstruction (Including Trauma-Related Fistula) I (MP48)1 May 2024MP48-12 CLINICAL OUTCOMES OF UROLOGICAL RECONSTRUCTION DURING CYTOREDUCTIVE SURGERY WITH HYPERTHERMIC INTRAPERITONEAL CHEMOTHERAPY Dyvon T. Walker, Margaret Higgins, Salvador Rodriguez Franco, Rebeca Gonzalez Jauregui, Rohan Bhalla, Derek Wengryn, Brian J. Flynn, Steven A. Ahrendt, and Ty Higuchi Dyvon T. WalkerDyvon T. Walker , Margaret HigginsMargaret Higgins , Salvador Rodriguez FrancoSalvador Rodriguez Franco , Rebeca Gonzalez JaureguiRebeca Gonzalez Jauregui , Rohan BhallaRohan Bhalla , Derek WengrynDerek Wengryn , Brian J. FlynnBrian J. Flynn , Steven A. AhrendtSteven A. Ahrendt , and Ty HiguchiTy Higuchi View All Author Informationhttps://doi.org/10.1097/01.JU.0001009512.15743.d7.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In the last two decades, cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) has become standard of care for resectable peritoneal carcinomatosis. CRS aims to eliminate visible disease, while HIPEC targets microscopic disease. Urologic involvement in CRS/HIPEC cases occurs in 7-20%, with no known negative impact on complications, morbidity, or mortality. The challenge with urologic reconstruction in this context stems from poor tissue quality. There have been no prior studies to our knowledge comparing surgical outcomes of urologic reconstruction before and after CRS/HIPEC. We aimed to examine our institution's experience. METHODS: We conducted a retrospective analysis of 314 CRS/HIPEC procedures between June 2010 and August 2023. Data included patient demographics, pre-existing co-morbidities, intraoperative details, and post-operative outcomes. Table 1 shows a breakdown of pre-operative patient characteristics, as well as intra- and post-operative outcomes, including short-term (prior to discharge) and long-term (greater than 1 month post-op) urologic complications. RESULTS: Out of the 314 cases, urologic reconstruction occurred in 35 (11.1%). Among these, 24 were intraoperative consults and 11 were planned preoperatively. Urologic repair was done after administration of HIPEC in 22 cases (63%). Notably, 57% (n=20) experienced a postoperative urologic complication, and 29% (n=10) had long-term sequelae (ureteral stricture, retention, incontinence, fistula). Of note, 8 patients had both short- and long-term complications. Table 2 presents an analysis of pre- and intra-operative factors between patients with and without a long-term complication. CONCLUSIONS: Urological reconstruction in CRS/HIPEC adds complexity to post-operative recovery. Our findings suggest that the long-term urologic complication rate remains relatively comparable when compared to overall complications associated with these procedures. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e777 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Dyvon T. Walker More articles by this author Margaret Higgins More articles by this author Salvador Rodriguez Franco More articles by this author Rebeca Gonzalez Jauregui More articles by this author Rohan Bhalla More articles by this author Derek Wengryn More articles by this author Brian J. Flynn More articles by this author Steven A. Ahrendt More articles by this author Ty Higuchi More articles by this author Expand All Advertisement PDF downloadLoading ...