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Peritoneal based Malignancies

Peritoneal based Malignancies - How to prevent?

Peritoneal based Malignancies - Causes and Risk Factors

​As with all surgical procedures, complications can occur. Some of these risks and complications are inherent in any operative procedures, especially when general anaesthesia is administered. Complications can cause a prolonged hospitalization stay or discharge with significant home care needs. Every effort will be made to minimize the risk of having a complication; and to help you cope if a problem occurs. Your surgeon will speak to you more about these risks.

Some of the possible complications following this CRS and HIPEC are listed below. Selected complications are explained in detail below. More information will be given to you by your surgeon.

Early postoperative
• Anastomotic leak
• Postoperative bleeding
• Wound infection
• Intra-abdominal infection/collections
• Deep vein thrombosis (DVT)
• Chest infection
• Urinary tract infection
• Prolonged ileus
• Electrolyte disturbances
• Immunosuppression
 
Late postoperative complications
• Intra-abdominal infection/collections
• Entero-cutaneous fistula
• Intestinal obstruction
• Bladder and sexual dysfunction ( pelvic dissection cases)
• Stoma-related complications

Anastomotic leak
An anastomotic leak can be a very serious complication after the operation that can lead to severe intra-abdominal infection. This may require prolonged hospitalization for intravenous antibiotics or even further surgery. In our experience, the risk of an anastomotic leak is 5%. In rare instances, a leak can present with discharge of intestinal fluid from the operative wound or skin in the form of a fistula (an abnormal passage between two organs in the body or between an organ and the exterior of the body), which will delay recovery and might even require another surgery.

Postoperative bleeding
This can occur in 1-3% of patients and in severe cases might require a repeat surgery to stop the bleeding.

Wound infection
Wound infections occur in about 5% of patients. This complication may prolong the hospital stay and delay the healing of the wound. Occasionally your wound may need to be laid open to facilitate with cleaning. Antibiotics will also be given.

Intra-abdominal infections/collections
Infection within the abdomen can result in abscesses and collections. If these are small, a course of antibiotics is sufficient. However, larger fluid collections will require drainage under radiological guidance or by open surgery.

Chest infection
Chest infection can develop after any major surgery, especially after abdominal operations, this is especially so for patients with pre-existing lung disease, and in smokers. This can prolong the hospital stay requiring intravenous antibiotics and chest physiotherapy. It is essential that you participate fully in your post-operative chest therapy to minimize the risk of a chest infection.

Bladder and sexual dysfunction
The risks of bladder and sexual dysfunction are increased when the surgery entails working within the pelvis. The problems include difficulty passing urine and impotence. The risk increases when radiation is given as part of treatment.

Stoma-related complications
Such complications are rare, but include prolapse (protrude excessively),  retraction into the wound and parastomal hernias. This may be managed conservatively, with surgery only becoming necessary if it causes a lot of discomfort and becomes difficult to apply the stoma bag onto the skin. Skin irritation around the stoma may result, especially when the stoma bag is not properly applied and this can be managed with topical creams.

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