Ureteral stenting in cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy as a routine procedure: evidence and necessity

Urol Int. 2012;89(3):307-10. doi: 10.1159/000339920. Epub 2012 Aug 1.

Abstract

Introduction: There is a need for more exhaustive data concerning the use of prophylactic ureteral stenting for extended debulking and cytoreductive procedures in the literature.

Material and methods: A retrospective analysis of the CARPEPACEM study protocol database was performed. The trial protocol schedules the positioning of bilateral ureteral stents before cytoreductive surgery + hyperthermic intraperitoneal chemotherapy (HIPEC).

Results: Fifty-one operated patients: 31 (59.6%) with peritoneal dissemination from ovarian cancer, 8 (15.3%) from colorectal cancer, 4 (7.9%) from pseudomyxoma peritonei, 3 (5.7%) from gastric cancer, 2 (3.8%) from peritoneal mesothelioma, 1 (1.9%) from appendiceal cancer, 1 (1.9%) from endometrial cancer, and 1 (1.9%) from leiomyosarcoma. Mean and median peritoneal cancer index: 11 and 10 (range: 0-28). CC-score: CC-0 in 45 (86.5%) patients, CC-1 in 5 (9.6%) and CC-2 in 1 (1.9%). HIPEC was performed with platinum + taxol in 22 patients (42.3%), platinum + adriablastin in 10 (19.2%), mitomycin in 9 (17.3%), platinum + mitomycin in 7 (13.4%), platinum + doxorubicin in 2 (3.8%), and taxol + adriablastin in 1 (1.9%). Two major ureteral complications were observed (3.9%).

Discussion: Prophylactic ureteral stenting could reduce the risk of postoperative ureteral complications without an increase in stent placement-related complications; however, a randomized clinical trial is needed.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Chemotherapy, Cancer, Regional Perfusion / methods
  • Female
  • Humans
  • Hyperthermia, Induced / methods*
  • Infusions, Parenteral
  • Male
  • Middle Aged
  • Peritoneal Neoplasms / complications
  • Peritoneal Neoplasms / surgery*
  • Retrospective Studies
  • Risk
  • Stents*
  • Ureter / pathology*
  • Urologic Surgical Procedures / methods*