GASTROINTESTINAL FISTULA FOLLOWING CYTOREDUCTIVE PROCEDURES FOR PERITONEAL CARCINOMATOSIS - INCIDENCE AND OUTCOME

The prognostic variables regarding the incidence of postoperative gast rointestinal fistula formation in patients treated with cytoreductive surgery and intraperitoneal chemotherapy for peritoneal carcinomatosis were analyzed. The overall fistula incidence was 15.5 (27/174). There was one death in this group of patients (4%) and 4 patients (15%) req uired ostomy construction at the fistula site for long term maintenanc e. The median length of hospital stay was 46 days (range 18-20). Clini cal features that correlated significantly with fistula formation incl uded bowel-obstruction preoperatively (63%), prior intraabdominal ther apy (27%). Only one patient without bowel obstruction and without prio r intraabdominal therapy developed a fistula for an incidence of appro ximately 1%. Reoperative surgery was associated with a higher incidenc e of fistula development than an initial cytoreductive procedure but t his difference did not reach statistical significance. Also sex, age, and site of primary tumor were not statistically significant variables . In treating peritoneal carcinomatosis patient selection is important in that some patients are at especially high risk for fistula formati on.